Can Learning Social Skills in School Pay Off Beyond the Classroom?

This post was originally published on The Robert Wood Johnson Foundation’s Culture of Health blog.

This is the first of a 5-part blog series, curated by RWJF, a TEDMED Global Partner. This blog series showcases the real and tangible ways that communities around the country are supporting the healthy development of children and young adults. The series helps to set the stage for the important conversations about child health and development that RWJF will host at TEDMED this year.

By Mark Greenberg and Tracy Costigan


Social emotional skills can help students set goals for themselves and build positive relationships with peers. They can also lead to long-term societal benefits that extend far beyond the individual child.

At an elementary school in the Menominee Nation in Wisconsin, the school day starts in an unusual way. Before they do anything else, students sit down at a classroom computer and select the face that best matches how they feel that morning.

If they’re feeling upbeat, they pick a green, smiling face. If they’re upset about something, there’s a red sad face. And if they feel somewhere in the middle there’s a yellow neutral face. This exercise helps these students develop self-awareness and emotional management skills. It also helps teachers recognize which students are having a tough day and where they might need help.

Ryan Coffey, a teacher and counselor at the Wisconsin school, calls this simple check-in an incredible tool that “can change the whole day.”

A 2nd grade Menominee student starts the day with mindfulness meditation.

“It’s about being proactive—before they blow up—instead of reactive. Because [incidents in the community] are hard on them, hard on their classmates and hard on their teacher. It’s traumatic for everyone. When they get older, those negative coping skills lead to the smoking, the drinking, the drug use. If we give them positive skills now … those are life skills they’ll use forever.”

This community has recognized, and put into practice, what research increasingly shows is clear: social emotional development is essential to long-term wellbeing and success.

In fact, building social emotional skills in students as young as kindergartners can have long-term benefits, not just for the students themselves but for society as a whole. Every dollar invested in effective social emotional programs in schools can bring an average of more than $11 in benefits in the long run.

These benefits come in a few different ways. First of all, students with stronger social emotional skills tend to do better in school. One study of eighth grade students found that a measure of self-discipline—one aspect of social emotional development—was a better predictor of grades, school attendance, and admission into a competitive high school program than even IQ.

Secondly, social emotional development can help students graduate from college and land a well-paying job. Children who demonstrate greater social emotional skills as young as kindergarten are more likely to have graduated from college and hold a full-time job 20 years later. Adolescents with these skills earn more as adults.

The long-term benefits of self-control, managing one’s emotions, and building strong relationships extend beyond the educational setting itself. Research shows that children with a stronger social emotional skill set were less likely to experience health problems, struggle with substance abuse, or engage in criminal activity as they got older.

All of these positive long-term outcomes benefit not just the student, but broader society. For instance, when students succeed in school and grow up to become productive adults, they’re ultimately supporting the overall well-being of their neighbors and communities. If, as adolescents grow older, they avoid substance abuse and crime, they’re also preventing associated societal costs.

Now, it’s no secret that investing early, supporting the whole child and student early on, pays off in the long run. Additional research further illustrates how early education programs promote social mobility within and across generations, helps prevent obesity, reduce health care expenditures and leads to overall higher-quality of life.

But what is new and exciting is that more and more schools are putting these social emotional principles and programs into practice the way the Menominee Nation is. Schools have always focused on building the academic skills and knowledge of students, and we’ve always viewed that as a long-term investment in our human capital. A large and growing body of research should make it clear that supporting students’ social, emotional, and physical health is just as strong an investment.


Learn more about research from RWJF and Pennsylvania State University, covering how teachers, parents, schools and others can support the social emotional learning of students.

Talking about our health

Many of us have experienced some level of anxiety at the doctor’s office. There we are, sitting in a chilly room dressed in a paper thin, wearing an open-backed robe, and feeling vulnerable. We find ourselves tempted to exaggerate the amount of time we spend at the gym each week or to downplay the number of cocktails we drink on weekends. We are itching to ask whether our contact lenses can get lost in our eyes, or if that new juice cleanse has any merit—but we don’t. From worrying about looking foolish to fearing that you’ll learn that a weird mole may be much more serious than you thought, there are any number of reasons why we don’t ask our doctors the health questions that plague us. And as a result, there’s a breakdown in communication about one of the most important things we have—our health. At TEDMED this year, we’ll hear from Speakers and Innovators who are actively improving the way we approach conversations about health and the decisions we make about our care.

When communicating with your doctor, it can often feel like you don’t speak the same language. Maybe they use medical terms you don’t understand or offer prescription advice so quickly that you’re not able to absorb the fine details. However, working with your physician and navigating the health care system gets infinitely more difficult when they literally don’t speak the same language as you. That’s where ConsejoSano, founded by Abner Mason, steps in. ConsejoSano is the country’s only patient engagement and care navigation solution for the 54 million Hispanic Americans who prefer to communicate in Spanish. Driven by the goal to meet “people ‘where they are’, linguistically and culturally”, Abner believes that the company’s data analytics, multi-channel messaging, care navigation, and round-the-clock access to native Spanish­-speaking medical advisors will be the formula needed to tackle health disparities and improve outcomes for the underserved Hispanic population.

Even when there’s no language barrier between you and your doctor, having an open and honest conversation with them can sometimes feel awkward. James Hamblin knows it can be uncomfortable to have frank conversations about our health, so he uses humor to answer many of the questions that cross our minds, but that we feel nervous to ask aloud. His columns and videos for The Atlantic acknowledge that healthy choices rarely fall under “all” or “nothing” labels, and that real people fit into those categories even less frequently. James tackles complicated questions like, “if someone chooses to smoke, should they smoke filtered cigarettes?” and fundamental curiosities such as, “how does sunscreen work?” His light-hearted and fact-driven approach makes the conversation about healthy living less intimidating and more accessible.

Like James, Meg Gaines feels strongly that patients need to take a more active role in their own health. As a cancer survivor and attorney in Wisconsin, Meg is committed to improving the physician-patient relationship, which can often be defined by either distrust or implicit trust. Meg says that both can be dangerous. Meg’s philosophy is that by laying a foundation of patient, family, and community participation in health care, we can reframe the idea of health care “delivery” to health care “co-creation.”

Even when we’re able to work closely with our physicians and take control of our own health, many of us are prone to falling back on long-held beliefs and resisting scientific facts. Sara Gorman’s work examines the reasons why it’s so difficult for us to change our minds, even in the face of evidence. For example, why do so many people believe vaccines are harmful, when there is scientific evidence that they are not only safe, but beneficial to our health? Like Meg, Sara advises physicians and health care providers to reconsider their approach with patients. She also offers tips on how providers can help patients understand the health-related options they have and the role providers play in assisting people to make scientifically sound decisions.

Unfortunately, the science isn’t always so black and white. What do we do when trusted news sources treat ongoing scientific investigations as a series of press releases? Massive Science, co-founded by Nadja Oertelt, wants to change the way science is reported. Their mission is to provide accurate, detailed, and clear science stories to the public—directly from researchers and scientists. By working closely with scientists, and helping them to talk about their work in ways that the broader public can understand, Massive is opening up lines of communication between scientists and the science-curious.

Whether it’s making health conversations more accessible, helping people change their minds in light of new evidence, or taking a new approach to sharing scientific data, these Speakers and Innovators see value in improving the way we approach conversations about healthcare and health-related science. By improving lines of communication between patients and physicians—and getting everyone on the same page—we can expect higher patient compliance and better health outcomes.

Patient-artists in medical schools

The trend of including the arts and humanities in the medical education realm is growing rapidly. Studies show immersion in the creative arts improves students’ observation skills, empathic engagement, and even a comfort with ambiguity. Major medical schools around the United States are investing in artists and creating innovative programs, and patient-artists are leading the way.

As Artist-in-Residence at the University of California Los Angeles and now at the University of Southern California, I have been honored to curate gallery shows that have energized the student body and faculty into engaging around topics that bridge the continuum from bench research to patient care.

At the Keck School of Medicine at USC, this curation has produced exhibits that illustrate the patient experience to future medical students, faculty and researchers. The idea is that a painting or work of art can reveal useful information about a patient’s lived experience better than the medical record or a list of lab values can. This is what has led the school to integrate the shows with its core curriculum in the first 2 years and explore the possibilities that have opened up. Interviews with the artists followed by Q&A with the students have led to discussions about the clinical gaze, embodiment of illness, metaphorical language and how visual representations can allow patients and doctors to bridge the communication divide effectively and with compassion.

Image from “Artist & Researcher.” By Qathryn Brehm, Los Angeles, CA

A perfect example of this is Siobhan Hebron, a performance artist with a brain tumor. She describes her experience of living with a serious and life-shortening diagnosis with an unflinching gaze and in this way allows the viewer into an empathic engagement without resorting to a reductive stance. She is much more than her illness, and yet she is also ruled by her illness. Such is the tension that exists in the lives of those who are living with chronic or life-threatening illness. And this is the landscape that the physician of the future will have to become familiar with as technological advancements make living with chronic illness a broader and more common reality.

In the Spring/Summer of 2017, I organized “Artist & Researcher,” a show that paired artists from the community with USC’s medical researchers to create visual and representational art about their research. The thought was that translating the impact and the beauty of the research in this way would inform the lay public, patients and the medical community in general about the work being done on campus. When the show was conceived my assumption was that the flow of information would go in one direction, researcher to artist. The researcher would explain and the artists would create. However, something quite unexpected was noted to happen: the researchers said that their conceptualization of the work was altered by having such in-depth discussions with non-researchers, and that the artist’s depiction of their research gave them a fresh outlook on the subject.

Image from “Pain”, a mail in art show at USC’s Keck School of Medicine. By H.M. Murphy, San Diego, CA.

In the Fall of 2017, the show “Pain 2” explores pain and the different ways that people from different cultures might depict the subject. An international call for mail-in art was sent out earlier in the year, and the gallery received over 300 pieces of mail from 18 countries. Images about subjects as varied as a simple stubbed toe to cancer, suicide, parental detainment during WWII, to life in prison and ever-present back and head pain came in packages and postcards of all sizes and shapes. The results were revelatory. As a patient with a painful illness of my own (Gaucher Disease) I had assumed that the majority of images would be about physical pain, but in fact, almost 40% touched on emotional pain and depression. There was also one image decrying the pain of a parking ticket. A favorite pieces of mine.

Solo artist shows, mail in art show or artist and researcher shows, the response from the medical community and public has been immediate and positive. The level of engagement in the sciences is enhanced by this transmission of ideas in the visual medium, while the creativity and risk-taking inherent to the arts, in turn, informs the research process and brings us closer to the consilience of these two seemingly disparate yet deeply connected realms.

These art exhibits and the patient-artists who make this kind of art serve as a potent resource for the medical educator training the next generation of doctors. The lessons these patient-artists embed into their work are not to be found elsewhere, and do justice to the complexity of illness in a manner not available in any other medium.

Healthcare Accessibility: A Look At The Numbers

At TEDMED this year, we will hear from three Speakers and Innovators who approach health care through the lens of economics. Through their work, we will explore different ways to think about allocating our finite resources in a world of limitless possibilities.

A natural experiment is an observational study that allows for the random—or seemingly random—assignment of study subjects to different groups. These kinds of experiments are rare but important when studying ideas that are impossible or unethical to recreate in the setting of a controlled experiment. Former Emergency Department social worker-turned-Medicaid researcher Heidi Allen seized the opportunity to study one such organic experiment in 2008, when the state of Oregon decided to expand its Medicaid program. There were 90,000 people who signed up for the expanded program, but as a result of limited funding, only 10,000 people were chosen to participate by random lottery. This unique circumstance provided Heidi and her team of researchers a randomized controlled trial with which to study the effects of Medicaid coverage.

The experiment’s results were complicated in terms of their impact on the newly-covered patients. Some outcomes were clearly positive—such as patients experiencing declining rates of clinical depression and financial stress as their medical debts decreased. Other results were less desirable. For instance, data indicated that the newly covered patients’ physical health markers—such as blood pressure, cholesterol, and cardiovascular disease—did not significantly improve. Along with these results, valuable lessons were learned. Heidi’s landmark research helped uncover truths about the role that health insurance plays in the lives of low-income Americans with limited access to coverage.

Even for people with health insurance, trying to understand or predict the costs that will accompany health care can become overwhelming. Often, it’s impossible to ascertain the cost of medical procedures in advance, and it’s not unusual for surprise bills to arrive months after your appointment. Eligible co-founder and CEO Katelyn Gleason wants to take the mystery out of medical billing. By integrating with existing medical systems, Eligible offers patients up-front information on the price of their procedures and co-pays, allowing them to pay at the time of service instead of waiting for months to receive a bill. Eligible not only benefits patients, but also physicians—who are saving valuable time not having to track down patients’ payments, helping them to collect up to 700% more revenue at the time of service.

While Katelyn is helping patients and providers demystify health care billing, health policy expert Amitabh Chandra is focusing on the important role that precision medicine will play in the future of drug pricing. Amitabh encourages us to consider the economic choices necessary to fund the next generation of medicine, in which the creation of targeted therapies that apply to smaller groups of people will change the economics of pharmaceuticals as we know it.

Funding and research in precision medicine are booming and for good reason: this approach hopes to maximize efficiency when treating disease. Currently, the Orphan Drug Act and other FDA regulatory incentives provide economic impetus for pharmaceutical companies to pursue precision medicine research. Yet it’s important to recognize that smaller markets, less competition, high technological manufacturing costs, and increased effectiveness could all result in eventual rising drug prices. Amitabh explores how we can incentivize companies to continue making precision therapeutics that patients can actually afford.

We are excited to hear more from each of these TEDMED Speakers and Innovators about their work investigating ways we can maximize our resources in economically sustainable ways. Join us at TEDMED this year to get to know them and their work better.

What Home Means to Health

As the WHO explains, individual and community health is driven by a variety of factors including the “social and economic environment, the physical environment, and an individual’s behaviors and characteristics”. Only when a person’s social and physical environments are taken into account can we address his or her full health profile from a comprehensive and holistic perspective. This year, we will hear from Speakers and Hive Innovators who are digging into these critical social and environmental factors as a means to improve health.

Miners in Appalachia began the process of mountaintop removal (MTR) coal mining—literally blowing off the tops of mountains—in order to access coal with lower sulfur content. While this type of surface mining holds fewer health risks for miners, the health implications for people living in close proximity to MTR locations had long been unknown. After moving to West Virginia, Professor Michael Hendryx became fascinated by this process of coal extraction and began to study the relationship between mountaintop removal coal mining and the health of people in nearby communities. He discovered an independent correlation between poor health outcomes and proximity to MTR sites, likely due to increased levels of the toxicant crystalline silica (a known contributor to lung cancer that is released from coal). Michael’s findings have been met with strong political resistance, perhaps, in part, because they are based on correlations, rather than causation. As he works to establish direct connections between environmental effects and physical health, mountaintop removal coal mining continues to take place, unleashing salts and trace minerals into the air and nearby mountain streams. Michael is hopeful that his research will encourage policymakers to consider the full picture when assessing the environmental impacts of any energy source.

Like Michael, Sara Vander Zanden of The BLOCK Project recognizes that where someone lives greatly contributes to their health. The BLOCK Project presents a new solution to homelessness, encouraging communities to place a BLOCK Home in the backyard of a single-family home on residentially-zoned blocks in Seattle, Washington. Their artfully designed 125-square-feet homes are off the grid and equipped with a kitchen, bathroom, sleeping area, composting toilet, greywater system, and solar-panels. The BLOCK Project aims to “offer opportunities for healing and advancement to those formerly living on the fringes of society” by fostering connection and community relationships, halting the emotional and physical separation that coincides with the social injustice of homelessness.

A BLOCK Project home, designed by BLOCK Architects.

Surprisingly, our physical environment’s impact on our health starts as early as in our first home—the womb. In her research, neuroscientist Jill Goldstein explores the impact of a fetus’s physical environment on the prenatal development of the brain. Jill’s research has identified that prenatal disruptions (such as a traumatic experience or chronic stress) for a pregnant mother can impact her developing fetus’s brain circuitry. These changes in circuitry can predispose the fetus to certain chronic diseases—such as depression or CVD—years down the line. Stressful external circumstances—such as living in socioeconomically disadvantaged areas—can be physiologically internalized and not only affect an expectant mother’s well being, but also that of her unborn baby.

As these Speakers and Hive Innovators show, addressing the influences of our social and physical surroundings can improve health outcomes beyond the limits of our previous understanding. We’re excited to showcase these individuals and their game-changing work at TEDMED 2017—and we hope that you’ll join us.

Impacting the way we approach family planning

In the United States, 45% of pregnancies are unintended. Just under half of those pregnancies are aborted. Since the conception of birth control pills in the 1960s, the role of preventing unplanned pregnancy has largely been seen as a “women’s issue”. Andrologist John Amory is determined to change that, by enabling men to share greater responsibility for family planning with the development of a better, novel form of male contraception. For over 100 years, there have only been three forms of male contraception – condoms, vasectomy, and abstinence.

Dr. John Amory in his lab at the University of Washington Health Sciences in Seattle, WA.

The development of male contraceptives poses unique physiological challenges. Unlike the female reproductive system which experiences periods of fertility and infertility at regular intervals each month, the male reproductive system is constantly fertile, making 1,000 sperm every day from puberty until death. John is exploring the use of testicular retinoic acid biosynthesis inhibitors to block sperm development as a reversible male contraceptive. Undaunted by the many challenges of his work, John is committed to creating a contraceptive that promotes greater sharing of responsibility between both sexes when making decisions about family planning.

While John is helping parents delay pregnancy until the time is right, for many parents the decision of when – or whether – to have a baby is influenced by biological factors outside of their control. When pregnancy does occur, the fertilized embryo has three genomes: one set of nuclear DNA from dad and one set of nuclear DNA from mom, plus an additional mitochondrial DNA (mtDNA) inherited exclusively from the mother. Mitochondria, or “powerhouses of the cell”, have their own set of DNA which codes for proper energy production and cellular function. Mutations in mtDNA result in a spectrum of incurable diseases, commonly presenting with symptoms like muscle weakness, seizures, developmental delay, or organ failure.

So what if a woman with unhealthy mtDNA wants to become a mother without risking the health of her baby? University of Newcastle professor Mary Herbert provides a solution by transferring a woman’s nuclear DNA and a man’s nuclear DNA into a donor egg containing healthy mtDNA, from which the existing nuclear DNA has been removed. This allows the woman affected by mitochondrial disease to have a child without passing on mutations in mtDNA. The donor egg provides a subset of DNA to the baby, but the genetic characteristics of the baby are completely determined by the nuclear DNA, not by the mitochondrial DNA of the donor. Through this work, Mary is pushing the limits of our understanding of reproduction and looking toward a future where certain mitochondrial diseases can be eliminated from a family for generations to come.

Mary is helping women who carry genes for devastating diseases conceive healthy babies, but what is being done to help women have safe deliveries during childbirth?

Compared to countries of similar wealth, women in the United States have a greater risk of maternal mortality with rates increasing 27% since the year 2000. According to the CDC, 60% of these deaths are preventable, commonly resulting from complications like maternal hemorrhage which can arise without the warning flags of predisposing risk factors, making it difficult to predict. Siddarth Satish, founder of Gauss Surgical, realized that every vital sign is carefully measured in an operating room – except for blood loss. He created Triton OR, an FDA-approved blood loss monitor that provides real time feedback on blood loss, optimizing transfusion decision making and predicting postoperative hemoglobin levels. Siddarth’s innovation helps improve patient outcomes, with the ability to help make childbirth safer – for both the child and the mother.

These 2017 TEDMED Speakers and Hive Innovators are moving beyond what were once thought to be limits when it comes to family planning and childbirth. Join us this November to hear their stories.

We shouldn’t wait for child sexual abuse to occur before we act to prevent it

Written and submitted by Elizabeth Letourneau.

Elizabeth is the inaugural director of the Moore Center for the Prevention of Child Sexual Abuse and Professor at the Department of Mental Health at Johns Hopkins Bloomberg School of Public Health, and is a past president for the Association for the Treatment of Sexual Abusers. Elizabeth spoke on the TEDMED stage in 2016, and you can watch her talk here.


Child sexual abuse is a preventable problem that causes needless suffering and harm. We can prevent it, yet we wait before we intervene, usually acting only after harm has occurred. Most cases of child sexual abuse – about 80% – occur in someone’s home while nearly 20% take place in institutions, including schools, camps, religious facilities, foster care and other youth-serving settings. In rare instances, abuse occurs in public spaces such as parks or shopping malls. Different settings offer different challenges and opportunities for prevention. Likewise, people who engage in harmful sexual behavior with children do so for a variety of reasons.

It’s not widely known that children and adolescents account for as many as half of all sexual offenses against young children. They may be acting impulsively, acting out their own abuse, or experimenting with age-inappropriate partners. Many simply may not know that engaging younger children in sexual behavior is harmful. Likewise adult offenders engage in these behaviors for many reasons. Different prevention programs and policies are needed to address the different factors that influence child sexual abuse.

To a large degree, our nation has ignored prevention in favor of after-the-fact interventions that focus on mandated reporting and criminal justice sanctions. When we have focused on prevention, it has been with school-based programs that attempt to train children to distinguish between good and bad touches. Yet no single approach can possibly be sufficient. What is needed – what is long overdue – is a comprehensive public health approach to the prevention of child sexual abuse.

We do not need to start from scratch to develop a national public health approach to child sexual abuse. Many youth-serving organizations already mandate child sexual abuse prevention training for staff and volunteers. We can look to them for good and promising practices. For example, Boy Scouts of America requires two adults to be present for all interactions with children. Likewise, training programs have been developed by organizations such as Stop It Now! and Darkness 2 Light to help parents, teachers, and child care workers detect and intervene in child sexual abuse. Essential to these and other efforts is empirical evaluation to determine their effectiveness. We would not release a vaccine without rigorous testing, and we should not broadly disseminate prevention practices unless and until we are certain they do the job of preventing sexual abuse against children.

A comprehensive public health approach will bring needed empirical rigor to this field and will help us expand prevention efforts to – for example – deter children, adolescents, and adults from engaging in abusive behaviors in the first place. As I discuss in my TEDMED Talk, we have begun to make exciting progress in this area.

A public health approach will also help us to move beyond focusing solely on the behavior of individuals to focusing on prevention at the community level, including design and messaging. For example, the Boys and Girls Clubs of America have invested deeply in identifying structural changes to their buildings that might reduce the risk of child sexual abuse. Some of their efforts, such as placing windows in all interior doors, increase the visibility of adult-child interactions. Does making such interactions more visible and “interruptible” discourage abusive behavior? Perhaps. But before we recommend that everyone remodel their buildings, it would be prudent to gather some data. The YMCA is looking into the use of creative signage to see if these can impact the behavior of adults towards children. Wouldn’t it be amazing if architects, structural engineers, and designers helped us solve the problem of child sexual abuse? The public health approach encourages such multidisciplinary collaborations.

There are no doubt myriad ways to effectively prevent child sexual abuse just waiting to be found. But we need the will to put significant resources into designing and testing these before-the-fact interventions. What we’ve been doing for the past 30 years – teaching our children how to protect themselves, mandating teachers and others to report abuse, and relying on law enforcement strategies – just isn’t enough. We can do much better. We can develop and fund a national public health prevention program to keep children safe from sexual abuse.

Human Potential at Work

Each year, TEDMED features stories and individuals that challenge our perceptions of limits and encourage us to imagine what’s possible. This November, two Speakers and two Hive Innovators will take the TEDMED stage and reveal how a better understanding of human nature may hold the clues to unlocking each individual’s unique potential.

Frans de Waal

For Frans de Waal, a primatologist and ethologist at Emory University, exploring human potential is directly linked to exploring the behavior of primates. By studying the ways primates behave under stress and how they make decisions, Frans adds context to our understanding of what it means to be an “alpha” female or male. Popular culture uses this term to refer to people who are controlling or sometimes even those who act as bullies; but in nature, an “alpha” is the highest ranking member of one’s sex and the animal that often assumes a leadership role by demonstrating qualities of solidarity, community, and experience. Frans’ observations on how human social structure mirrors primate social structure yield rich insights into our own society, what we value, and how we choose our leaders.

Whether you’re an elected official or the captain of your soccer team, becoming a leader often requires performing at your highest potential. But sometimes, when we feel pressure to perform at our peak, we falter. Barnard College President Sian Leah Beilock studies how people perform under stress and asks: why do we blunder when the stakes are high? Sian identifies how anxiety and stressful situations can actually create physical changes in our brains and rob us of our ability to perform our best. From students taking math exams to NBA players making free throws, Sian explores how we can adapt to perform under pressure. By channeling our focus, we can set ourselves up for success and enable ourselves to reach our potential.

Next, we shift our focus from individual performance to the abilities of large groups. Two Innovators from our Hive Program are focused on finding ways to improve overall health by creating tools that tap into the innate human potential to nurture and care for others.

Jo Schneier leads Cognotion and is working to improve the way we train caregivers, nurses, and nursing assistants to care for our rapidly aging population. To fix the shortage of qualified frontline healthcare workers, Jo believes that we must provide better training methods that empower workers and get them to work quickly. Cognotion’s unique program operates on the premise that there is narrative inherent in any teachable subject. Crafting this narrative into an immersive storyline, Cognotion’s story-based training tools feature high quality, high-production videos that engage learners using a medium that’s entertaining and familiar. And by connecting through story, learning happens on an emotional level that deepens understanding and maximizes impact. Through training programs that tap into the power of story, Jo’s goal is to not only transfer cognitive and physical skills, but to also instill dedication, confidence, and pride within our future healthcare workforce.

Mudit Garg is focused on improving healthcare operations to maximize medical professionals’ impact. Using an AI platform to monitor hospital data in real-time, the Qventus platform acts as a virtual air traffic controller for hospitals, helping to remove decision-making overhead from staff so that they can spend more time focusing on the patient experience and providing care. The software learns over time and is able to predict issues before they occur, recommend immediate actions, coordinate across teams, and engage the best team members for response. Hospitals using Qventus are seeing benefits across a wide range of outcomes, such as reductions in patient falls, length of stay, unnecessary lab tests. These benefits are having a clear positive impact on medical costs; and even better, doctors and nurses are focusing more time on providing care and improving patient outcomes and experience.

From examining our social structures and improving our personal responses to stress, to instilling caregiver training with a sense of meaning and leveraging the impact of health care providers through AI, these TEDMED 2017 thought leaders are helping us to be better equipped to activate our full potential. Furthermore, whether it’s through the lens of accomplishing personal goals or tackling problems in teams, these perceptive Speakers and Innovators are deepening our understanding of what it means to be human.

Promoting Health Through Policy

TEDMED celebrates the multidisciplinary approaches our Speakers and Innovators take towards shaping a healthier world. This year, we will hear from Speakers who are creating healthier societies on a government-wide scale. By prioritizing health policy, these individuals are taking proactive, systemic approaches to mitigate health risks in communities around the world.

When physician Agnes Binagwaho moved back to her native country of Rwanda in the aftermath of the devastating genocide, the country’s health care needs far outmatched its resources. Agnes knew she wanted to do something to help her country rebuild and become stronger. Agnes worked her way up to becoming Rwanda’s Minister of Health and led the effort of rebuilding Rwanda’s health care system from scratch. She implemented hospital infrastructure founded on communication, technology, and quality data and she instituted a comprehensive health information management system that helped fill in the gap left by the country’s lack of health care personnel. With this technology, Rwandans in the most remote parts of the country are now able to receive advice from health professionals and provide timely information regarding their community’s epidemiological status. As a result of Agnes’s leadership, Rwanda has had immense success in vaccination programs, touting 93% coverage for nine childhood vaccines, declines in maternal and child mortality rates by 60% and 70% respectively, and premature death rates for patients with AIDS and TB decreasing by 78%.

Like Agnes, former Senate Majority Leader and transplant surgeon Bill Frist understands that a healthy society can lead to a stable society. In the late 1990s, Bill and a team of physicians began making stealth medical mission trips to Lui, a remote region in southern Sudan. When they first arrived, they performed procedures in a bombed out schoolhouse. Slowly, year after year, Lui transformed from an area with no infrastructure and little commerce to home of one of the best-equipped hospitals in the area and a place where all people affected by the conflict could receive medical intervention. Recognizing that medical care was a foundation on which to build peace and trust, Bill promoted health interventions as a valuable form of diplomacy during his time as a legislator. After being called upon by President George W. Bush, Bill helped lay the foundation for the US President’s Emergency Plan for AIDS Relief, or PEPFAR, which was passed in 2003 with strong bipartisan support. The PEPFAR initiative has continued throughout presidential administrations, saving 11.5 million lives and increasing US approval ratings within the countries it operates.

Bill Frist in Haiti.

While Agnes and Bill have made great strides promoting health through policy at the national and global levels, changes at the local level are often critical in addressing individual health needs. In New York City, State Assemblywoman Linda Rosenthal is advocating for gender equity by fostering discussion and promoting policies around women’s health. One of the issues that Linda is tackling is the tampon tax. The average woman in America will use 300 tampons and pads each year, resulting in significant personal expenditures over a lifetime—a monetary cost that, in many states, is compounded by the taxes placed on these products. Linda has successfully repealed taxes on tampons in New York, giving the feminine care product—that was once taxed as a luxury good—the same exemptions as bandages and condoms.

Despite her achievement in removing the tax on tampons in New York, Linda recognized that many women and girls have a difficult time accessing feminine hygiene products in the first place. Today, Linda advocates for free tampons and sanitary napkins in low-income school districts, prisons, and homeless shelters. Often, only inmates who can afford the hygiene products receive them, and others must use rags or toilet paper to create makeshift tampons and pads, leaving them vulnerable to infection. In low-income schools, a young woman often has to wait in line at the nurse’s office to receive a tampon or pad, missing valuable time in the classroom. Linda is advocating for free bathroom dispensers to allow women to quickly acquire what they need so they won’t miss out on their educational experiences. Furthermore, Linda’s efforts are helping to ensure periods are understood as a healthy, normal occurrence, not a sign of sickness.

Whether they are addressing issues at the systemic or individual level—or working proactively to prevent them—smart policies have the power to improve and shape our health care. At TEDMED this year, we’re excited to hear more from these changemakers about their work improving the health of society through health policy.

Metformin and the TAME Trial: Magic Pill or Monumental Tool?

Written and submitted by Nir Barzilai.

Nir currently serves as Director of the Institute for Aging Research at Albert Einstein College of Medicine, where he is also Director of the NIH’s Nathan Shock Center of Excellence in the Basic Biology of Aging and the Paul F. Glenn Center for the Biology of Human Aging Research. Dr. Barzilai is also the Deputy Scientific Director of the American Federation for Aging Research (AFAR). Nir spoke on the TEDMED stage in 2016, and you can watch his talk here.


Today, the possibility of living healthier and longer is not science fiction—it’s science.

Thanks to the more than three decades of research in the basic biology of aging, a range of promising drug interventions are ready to transform growing older from a period of sickness to a period of vitality.

These interventions build on the knowledge that the biological processes of aging are the major driver of major diseases that afflict so many of us we grow older.

If we targeted or delayed aging, we could delay or prevent age-related diseases.The most promising effort is a new study, the TAME (Targeting Aging with Metformin) Trial: this novel clinical trial will test whether the drug metformin—a widely used, affordable treatment for type 2 diabetes—can delay the onset of age-related diseases including cancer, diabetes, and heart disease.

Funds must be secured in order to take what we have learned from the lab to human trials, but let’s be clear: metformin is not a magic pill.

Rather, the TAME Trial is a tool that can monumentally improve our health as we grow older. The metformin clinical trial will serve as the tool or framework for the most important medical intervention in the modern era since antibiotics—a new category of drugs that add years of healthy life as we age.

For each of us individually, TAME will help decrease disease. If successful, TAME is expected to lead to the use of Metformin and the development of other drugs to target aging and help delay or prevent the onset of debilitating conditions or diseases.

Plus, we will be less at risk for financial fraud or exploitation, as cognitive skills necessary for essential functions such as managing medications and finances—such as memory, reasoning, perception, and language skills—will be less impaired.

For society at large, the development of drugs resulting from the TAME trial will increase health care savings. A recent economic analysis showed that slowing or modifying age-related diseases by just 20 percent would save more than $7 trillion in health care spending in the United States alone over the next half-century.

We call this the Longevity Dividend: if we increase years of health as we age, we actually can decrease the financial burden of related healthcare costs.

Moreover, the TAME Trial would cost 96% less than the cost to develop and win market approval for a single drug: $69 million vs. $2.4 billion, as estimated in a 2014 Tufts University Study.

By focusing on metformin first, as a paradigm of a drug targeting aging, the TAME trial has the potential to unleash the powerful research and development engine of the pharmaceutical
industry to generate next-generation drugs, individually or in combination, to prevent and delay multiple age-related diseases.

In turn, we can transform aging from a period of sickness to a time of extended vitality, and age-related diseases can be treated more effectively and cost effectively.

In essence, we can live longer and live well.

With one American turning 65 every eight seconds today, the TAME Trial is a small investment that can make huge impact by saving trillions of dollars while invigorating millions of lives.

In an era of rising health care costs and unpredictable health care coverage, delaying or targeting aging could be the most efficient method of achieving primary prevention available to us in this century.

The field is ready to translate basic biomedical research into clinical trials like TAME, yielding therapeutic interventions that will extend health while decreasing healthcare costs.

With a concentrated, coordinated effort across the public, private, and philanthropic sectors, together we can move aging research from the labs into our lives.

The TAME Trial is poised to be a monumental tool to transform how we age.