New York City and Philadelphia: A Tale of Two Obesity Declines

By Risa Lavizzo-Mourey and Nancy Brown

“Severe Childhood Obesity Shows a Decline in New York City.” You might have seen the headlines earlier this month.

It wasn’t long ago that we never saw stories like that.

For decades, it was nothing but bad news – one story after another about a rapidly growing epidemic. Just two years ago, the Robert Wood Johnson Foundation and Trust for America’s Health predicted that, if trends continued the way they seemed to be going, more than 60% of adults in 13 states would be obese by the year 2030 – and have the extremely high medical bills to prove it.

But now, we’re finally starting to see signs of progress against an epidemic that was once feared to be unstoppable. Overall childhood obesity rates have stabilized. For the first time in a decade, data show a downward trend in obesity rates among young children from low-income families in many states. And, we’re seeing reports from cities and states that their overall rates of childhood obesity are decreasing: from California to West Virginia; from Anchorage, Alaska to New York City.

New York is a great example of a place taking a comprehensive, community-wide approach to reducing childhood obesity. The city has required group child-care centers to improve nutrition and nutrition education, increase physical activity, and limit screen time. “Health Bucks” enable lower-income families to maximize their purchasing power for fresh fruits and vegetables at local farmers’ markets. The city’s Department of Design and Construction provides architects and urban designers with guidelines for designing buildings, streets and urban spaces that support physical activity. Chain restaurants are required to post calorie information on menus, enabling customers to make more informed decisions. The education and health departments have collaborated on the “Move-to-Improve” program, which helps teachers incorporate physical activity through the school day.

We’re thrilled that these approaches appear to be paying off, but here’s the thing about that recent study on the most severe obesity cases: White children saw a more significant decrease than Latino or African-American kids.

This was true for overall obesity rates as well: Childhood obesity rates among White K-8 students in New York dropped from 17.6% in 2006 to 15.4% in 2010 – an impressive 2.2 percentage point decline. But the drop among Hispanic and African-American students was far less, just 0.9 and 0.4 percentage points, respectively. The disparity among upper- and lower-income students was even greater, a 1.4 percentage point decline compared to 0.7 percentage points.

This means that despite the overall progress, the disparities gap may actually be widening in New York.

In this respect, New York City truly illustrates where we are in this epidemic. Progress is possible, and happening, but this progress runs the risk of leaving some of our young people behind, and too many of those at greatest risk.

There is one notable exception to this rule—Philadelphia.  In Philadelphia, they’ve managed to reduce childhood obesity prevalence while also reducing obesity-related disparities.


Like New York, Philadelphia has addressed the obesity problem from many angles. The city, along with groups like the Food Trust, pioneered new financing strategies to bring full-service grocery stores back to underserved neighborhoods. The city improved food and physical activity in schools, and was one of the first jurisdictions in the country to remove all sodas and other sugar-sweetened drinks from public school vending machines.  In schools with American Heart Association Teaching Gardens, children grow their own healthy produce, and learn about the value of good eating habits. Complete streets policies make it easy and appealing for people to walk and bike throughout the city. More farmers’ markets are opening all the time across the city, and they use smart incentives to help lower-income residents afford fresh produce. Corner stores are offering healthy products and using in-store placement and marketing techniques that are boosting sales.

And guess what? Childhood obesity there fell 4.7 percent – and the biggest declines were reported for African American boys and Hispanic girls: 7.6 percent and 7.4 percent, respectively.

The challenge for all of us is this: How do we make the Philadelphia story everyone’s story, in every community?  How do we give every child in America an equal opportunity to grow up at a healthy weight?

On July 22, we’ll be addressing those questions and more at a TEDMED Google Hangout. Here’s who will be speaking:

  • Risa Lavizzo-Mourey, President and CEO of the Robert Wood Johnson Foundation
  • Nancy Brown, CEO of the American Heart Association
  • Don Schwarz, former Health Commissioner and Deputy Mayor for Health and Opportunity, City of Philadelphia
  • Elissa Epel, Associate Professor, UCSF School of Medicine
  • Lisa Simpson, President and CEO, Academy Health

Our conversation will be moderated by Richard Besser, Chief Health and Medical Editor for ABC News.

Do you have a question or comment for the speakers? A story about what’s happening in your community to promote healthy eating, or physical activity? An idea for helping kids achieve and maintain a healthy weight? We’d love to hear from you! Just comment on this post, or tweet using the hashtag #GreatChallenges.

We’re really looking forward to a lively, candid chat, and we hope you’ll tune in and contribute to the conversation!


8 Outstanding Co-Hosts Announced for TEDMED 2014

unnamed-1It’s almost here! TEDMED 2014 will take place in just under two months… and we’re proud to announce our “navigators” for this exciting adventure.


TEDMED curator and chairman Jay Walker will open the event on September 10 in Washington, DC and close our program on September 12 in San Francisco, CA.

In between, TEDMED Delegates will have the pleasure of meeting — or getting reacquainted with — some of the most energetic human dynamos and inspiring thought leaders we know.

In alphabetical order, our 2014 co-hosts will include:

Co-host Venue
TEDMED director of stage content Dr. Nassim Assefi
FUN FACT: A global nomad and self-proclaimed “thrillionaire,” Nassim is also the published author of a critically well-received novel, “Aria.”
Washington, DC
TEDMED Chief Operating Officer and partner Shirley Bergin
FUN FACT: As a child, Shirley loved Peter Pan and always wanted to visit Neverland. Today we call this mother of two un-Lost Boys, “TEDMED’s Superhero in Residence.”
San Francisco, CA
Geneticist, MacAurthur “Genius” Fellow and intellectual provocateur Dr. Carlos Bustamante
FUN FACT: When he’s not doing research or exploding old paradigms, Carlos can be found sailing – a sport he calls “the perfect combination of adrenaline and intellectual challenge.”
San Francisco, CA
TEDMED’s “keeper of the flame” and president, Jon Ellenthal
FUN FACT: The door to Jon’s office has a poster-sized patent for an amazing invention – himself – listing his parents Ira and Judy as the “inventors.”
Washington, DC
Globe-trotting medical emergency journalist (and Pulitzer Prize winner) Dr. Sheri Fink
FUN FACT: She has reported on health, medicine and science in every continent but Antarctica…apparently there aren’t many medical emergencies or wars among Emperor penguins.
San Francisco, CA
Founder and director of UCSF’s Neuroscience Imaging Center (and host of his own PBS special) Dr. Adam Gazzaley
FUN FACT: Knew from age 7 he wanted to be a scientist, now he relaxes with nature photography.
San Francisco, CA
Yale medical intern, UN Delegate and passionate global activist Dr. Sandeep Kishore
FUN FACT: Sunny is the only co-host this year who is a former TEDMED speaker.
Washington, DC
Engineer, inventor and PhD candidate at MIT David Moinina Sengeh.
FUN FACT: David is also a rapper and writer of song lyrics.
Washington, DC

With this outstanding team at the helm — and with more than 80 dynamic speakers including scientists, journalists, activists, performers, artists and other thought leaders on our unified, two-city stage — TEDMED 2014 promises to be an unforgettable journey into the realm of “Unlocking Imagination in Service of Health and Medicine.”

Join us in DC or SF for this unforgettable ride…and stay tuned for more exciting news about the event.

Meet the next 10 Startups Joining Us in the Hive 2014

Today we introduce 10 more health-tech startups to join the many members of The Hive we’ve already announced. Be sure to join us at TEDMED 2014 this September 10-12 in Washington, DC, and San Francisco, CA where you’ll be able to meet these startups in person. The companies we introduce below use the web, mobile devices, and sensors in exciting and innovative ways – read more about them on

AssayDepotAssay Depot has created an online marketplace that connects buyers and sellers of research services making scientific innovation accessible for everyone.

ClinicalBoxClinicalBox creates software solutions for healthcare providers whose patients require complex, high-cost procedures and care that requires a high level of coordination and engagement.

EzDermEZDERM provides an iPad-powered solution for physicians and their staff to intuitively document patient visits via touch-based technology, anatomically accurate 3D body maps, and hand-writing + speech recognition.

HumanAPIHuman API’s universal health data platform collects and normalizes health data from any source, and allows developers to easily integrate it into any application.

LivelyLively enables older adults to remain independent, safe from falls and emergencies, all while staying connected to family and caregivers.

ManaMANA Nutrition is working to save the lives of those suffering from acute malnutrition by producing a ready-to-use therapeutic food, carefully formulated to provide a child’s basic nutritional needs.

MobileOCTMobileOCT transforms any camera into a powerful epithelial cancer discerning device, providing those with camera phones, but without access to medical facilities, life saving diagnoses.

OculogicaOculogica is developing eye-tracking-based technology to simplify detection of brain injury by assessing function of the nerves that move the eye and mediate vision

TickitShift Health Paradigms helps physicians to get freely answered and honest responses from their patients with their product “TickiT”, which relies on the power of personalized surveys and visually appealing data collection to collect information about health behavior.

Uberuber Diagnostics uses advanced medical electronics and cloud technology to deliver mobile diagnostic solutions that can significantly improve patient care in developing nations.

Also, catch our latest interview on the TEDMED Blog with the brilliant minds who curated the 2014 Hive. This week, meet Regis Kelly, Director of the California Institute for Science and Innovation known as QB3, which is comprised of more than 200 quantitative biologists who are converting discoveries into practical benefits for society.

Check back next week when we will introduce more of this year’s Hive startups.

– The TEDMED Team

Match Great Science Minds with Passionate Managers

RegisRegis Kelly is the Director of QB3, the only one of the four California Institutes for Science and Innovation devoted exclusively to biology and the life sciences. He oversees an innovation center comprised of more than 200 quantitative biologists at three northern California campuses (UCB, UCSC & UCSF) who are converting discoveries into practical benefits for society.

Previously, Kelly was Executive Vice Chancellor at the University of California in San Francisco, responsible for the new Mission Bay campus, which is the center of academic planning for a 300-acre public/private biomedical research park in San Francisco. He also served as Chair of the Department of Biochemistry and Biophysics at UCSF; was the Director of UCSF’s Cell Biology Graduate Program; and was the Director of the Hormone Research Institute at UCSF. Today he remains Chairman Emeritus of the Bay Area Scientific Innovation Consortium (BASIC), is on the Malaysian Prime Minister’s Biotechnology Advisory Panel, and is a General Partner of Mission Bay Capital venture fund.

TEDMED: What’s the most remarkable innovation you are seeing in health tech or medicine, and what is driving it?

Kelly: Longevity research. You’ve probably heard about Calico, founded by Google, to stop or reverse the aging process. It’s a very exciting area with a surprising amount of progress being made.

We’re looking at cases where we medically accelerate the aging process, as measured by cognitive loss. For instance, elderly patients who undergo hip surgery or knee surgery are liable to suffer a severe cognitive loss. Radiation therapy on the brain, a traumatic brain injury, or a severe infection can also lead to cognitive loss. In the cases we’ve measured, the cognitive loss is caused by the way the immune system affects your hippocampus. And the mechanisms involved in medically accelerated cognitive loss are, as well as we can tell, identical to the normal process of aging in the brain. If we could slow down accelerated cognitive loss, I’m very confident those therapies would be beneficial for long-term cognitive loss, such as in Alzheimer’s.

This is not pie-in-the-sky stuff. At QB3 we have potential therapies in the pipeline and a pathway we can see getting into humans to test longevity. We’re talking about how we can get very close to an IND for phase 1 trials.

What is driving this is bringing together fields that hadn’t previously interacted. Normally, if you’re a neurobiologist then you spend your life in the neurobiology community; if you’re an immunologist, you do the same; and if you’re an imaging person or a physicist, you hardly talk to anyone else. Now, a marvelous synthesis among immunology, neurobiology, and imaging is producing spectacular results.

TEDMED: What’s the most important factor for entrepreneurial success in health tech—and is that different from your own key to success?

Kelly: We have 100 companies in the QB3 incubator right now, and we look at lots of companies that apply to our venture fund. We are always more responsive and excited about a company when there is clear passion from the founder or entrepreneur. If you come up with a great idea and you don’t have passion, then when something goes wrong you won’t fight through it to the end. People have to be prepared to pivot and change and adapt. It’s really about people with a commitment to making it happen.

The other thing necessary to successful entrepreneurship is people skills. Someone can’t start a company if they can’t build and work with other people. If they have ego problems and it’s all about them, it’s doesn’t work. People who can really build teams and teams that clearly love the leader work well. That’s a prognosticator that the company is going to succeed.

Of course, you’ve got to have an idea; almost everyone has a new idea in a new market. But the things that impress us are passion and people skills as well as the idea.

Is that different from my own key to success? Yes, on my good days, those are probably the keys to my success.

TEDMED: For entrepreneurs with needle-moving ideas in global health, what are the keys to finding collaborators and supporters across specialties, industries, and geographies?

Kelly: This is entrepreneurship 101, but you must identify your customers and know that your product is what they want and will pay for. Selling life sciences products is not like selling iPhones. You must be careful about working on your reimbursement mechanisms and find out: is this really needed, by how many people, and who is going to pay for it?

In digital health people will often say, “Well, I hired a doctor,” or “I have a doctor friend,” or “I have a doctor on my panel and he’s going to tell me how to do it.” That doesn’t work. You need to talk to many doctors. The Lean Launch Pad insists, for instance, that you talk to 100 customers before they go ahead with your company.

Finding collaborators in other specialties is really important, and is a huge challenge. Trying to match someone with brilliant scientific insights or access to a new disruptive technology with someone who understands how to run a business is what we call “the Boyer-Swanson problem.” The fortuitous thing that made it possible for Herb Boyer, a scientist who was in my department at UCSF, to start Genentech was that he ran into the young entrepreneur Robert Swanson, who knew nothing about molecular biology, but knew about starting companies. The two of them together got Genentech off the ground. Very few scientists have business acumen; 90 percent of the time, you need a Boyer-Swanson match, and finding that is hard.

The Swansons—the people with managerial and organizational skills—are people who just like starting small companies. They love the excitement of starting something from nothing and seeing something with 30 percent probability of success coming to an exit in 5 years. They like the whole process and being surrounded by other people with that passion. They’re serial entrepreneurs; you’ve got to get them between companies. It’s like getting to people between marriages.

TEDMED: In 2020, you’re asked to give a TEDMED talk about the biggest transformation you helped bring about in your field. What is it?

Kelly: I’d love to be talking about how we put together this consortium that’s producing drugs that are reducing cognitive loss and affecting longevity. In six years we’re not going to have those in the clinic, but we certainly could have them clinical in trials.

Also, I’m excited about helping to transform American research universities to work better with the private sector. I’d like the boundary between universities and early startups in the incubator space to be so porous as to be nonexistent. Not only would we be feeding people into these entrepreneurial incubators, but also we would be hearing back from them what academics should be studying.

This is what QB3 is trying to do. If we could say that this QB3-type idea has spread so that 50 percent of universities in America are doing something like this, then that would be a major contribution to society.

Live online event: A candid conversation about childhood obesity

On Tuesday, July 22nd at 2pm ET, TEDMED will host a special live online discussion with our nation’s forward-thinking health leaders to take measure of the progress and challenges in our ongoing struggle with childhood obesity. Guests include representatives from Robert Wood Johnson Foundation, the American Heart Association, Academy Health, the University of California, San Francisco and the City of Philadelphia. Dr. Richard Besser of ABC News will moderate.

Screen Shot 2014-07-15 at 1.30.35 PM

The national childhood obesity rate has leveled off. Cities and states that have been taking on this issue comprehensively are starting to see their childhood obesity rates drop. A CDC study published in February showed that national rates may be declining among our nation’s youngest children.

This is good news, but challenges remain. Rates are still far too high overall, and racial, ethnic, and socioeconomic disparities persist.

What needs to happen to show bigger results, faster? How do we make sure all children can grow up at a healthy weight? What are some of the underlying environmental and societal causes that must be addressed? What could corporate, community and policy leaders do to further address this critical public health issue?

Click here to RSVP for the Hangout and view more information on this important conversation. We’ll be taking audience questions via #greatchallenges and will answer as many as possible on air.

11 More: Here’s Our Sixth List of Hive Startups!

We’re announcing another 11 startups to be showcased in The Hive at TEDMED 2014, this September 10-12 in Washington, DC, and San Francisco, CA. These pioneers in medicine and health include innovators in health communications, clinical trials, connected devices, and crowdfunding, and join the many we’ve already revealed and the several others yet to be announced.

ChatrHealthChatrHealth provides tools combining evidence-based medicine and communication algorithms to improve patient care by promoting provider-patient dialogue and helping prevent medical errors, identifying at-risk patients.

CureLauncherCureLauncher is a service and platform that transforms the way patients in need are matched with clinical trials that fit their conditions.

etecteTect is enabling a new universe of connected devices – its first application takes medication compliance to entirely new levels: a capsule emits a digital wireless message when a patient ingests it.

EvotechEvolving Technologies is addressing the needs of patients and physicians in underserved markets with its low-cost endoscopy system powered by a laptop or tablet.

b6d33e98-37ff-4cc7-b4a9-20a6d539fb51mySugr is changing how people live with diabetes by leveraging non-traditional approaches to connecting treatment devices and striving to transform clinical therapy into a fun part of daily routine.

NovasentisNovasentis is working on designs for medical, mobile, and wearable devices that can “come alive” with movement and sound using flexible electro-mechanical polymer haptic actuators and sensor technology.

OrbisBiosciencesOrbis Biosciences has leveraged particle engineering to create a technology that controls drug delivery to make pharmaceutical products safer and more convenient.

RespiRespi has developed a smartphone-enabled spirometer to help people with chronic respiratory diseases, such as asthma and COPD, to regulate their medication and avoid asthma attacks.

SamaHopeSamahope provides hope to people with treatable diseases, around the world, by crowdfunding for overstretched and under-equipped doctors who are available to perform life-changing medical treatments.

SensiotecSensiotec‘s wireless and touch-less sensor technology can track vitals for hospital patients without electrodes, sensors, or pads. Its platform also provides real-time monitoring to trigger alerts to hospital staff when needed.

SeratisSeratis provides a way to bring together a patient’s entire care team on one mobile platform so clinicians can easily communicate with each other using secure messaging.

And don’t miss the latest Hive Curator interview on the TEDMED Blog this week, featuring Mohit Kaushal.  His career has spanned clinical medicine, venture capital, and health policy as a White House Health IT task force member and the FCC’s Connected Health Director.

Stay tuned as we continue to announce this year’s Hive startups.

– The TEDMED Team

Use Multiple Levers to Push the Needle

Mohit KaushalThrough a career that has spanned clinical medicine, venture capital, and health policy as a White House Health IT task force member and the FCC’s Connected Health Director, Mohit Kaushal has gained a unique and broad perspective on the challenges of healthcare technology. Last year he joined Aberdare Ventures, and he remains an Adjunct Assistant Professor of Emergency Medicine at George Washington University and an appointee to a committee that advises the Department of Health and Human Services on data access and use.

TEDMED: What’s the most remarkable innovation you are seeing in health tech or medicine, and what is driving it?

Kaushal: There’s no single answer, but there are a couple of themes I really like. Pure technology innovation is one big bucket that includes personalized medicine. Medicine is very reactive right now: we wait for people to become unwell before we treat them, especially with chronic disease. Personalized medicine is weaving genomics and real life data together to figure out when we can start managing people earlier in the progression of disease.

Deeper into that is using proteomics and epigenomics to understand the whole body’s network and signaling, and using that to better understand disease and to better target drugs. Many drugs, especially in cancer, are expensive, have terrible side effects, and only work for a certain proportion of cancers. And that’s because cancer is probably many different diseases. The notion of understanding disease at its core to better target drugs is remarkable, along with all the tools and technologies that enable that, such as genomic sequencing.

The other piece I’m very interested in is more on the delivery side: How do we reconfigure the delivery of care? How do we move from a system that’s been built for acute care, with big expensive hospitals and expensive doctors, to a system that takes care of patients in more cost-effective settings, such as outside the hospital? And how do we use technology to enable that?

The framework for that is data capture—remote devices and sensors, as well as data storage and analytics—to turn multisource data into insights and then allow us to intervene. That’s a convergence of connectivity, storage, analytics, and behavioral change. All of these are technologies that, wrapped around the right service models, will effect positive outcomes.

TEDMED: What’s the most important factor for entrepreneurial success in health tech—and is that different from your own key to success?

Kaushal: The most important factor for entrepreneurial success in any industry is the quality of the management team and a little bit of luck. If you have the best science and the best management team, you increase your chances of success.

To go deeper, the specific qualities depend on the thesis of the company. If you’re trying to start a biotech company, you’ll need a mix of people with clinical, scientific, and business skills; those are very specific to the company. But generically, success depends on a team that is cohesive and can execute together. At many stages of the company, you need someone who is the Jack-of-all-trades. That’s the person who is really putting it all together.

If you’ve met some of the best ones, they’ve got real drive, real motivation that is less about cash and more about changing the way we do stuff. All of them work extremely hard and face challenges. In a word, they have hustle.

Is that different from my own keys to success? I don’t know if you could call me successful! If the question is, “What is the key to success in venture capital?” there are some common elements, but it’s hard to say.

TEDMED: For entrepreneurs with needle-moving ideas in global health, what are the keys to finding collaborators and supporters across specialties, industries, and geographies?

Kaushal: From the global health perspective, each market is very different. We could divide this into two themes: one is a scientific theme. I mean, a pill is a pill; it will work anywhere. But on the delivery side, it is different from country to country. There are different rules, regulations, delivery mechanisms, and infrastructures everywhere.

The first thing to think through is whether the end product as a manifestation is scalable as it is, or does it need to be tweaked for local markets? It’s not like WhatsApp, where you can build a very small labor company in the Bay Area to deliver the fundamentally same service around the world.

In terms of partners, it really depends on the specific population, but what many early stage companies need are partners who have local insights and knowledge and can help navigate the local distribution.

TEDMED: In 2020, you’re asked to give a TEDMED talk about the biggest transformation you helped bring about in your field. What is it?

Kaushal: I’ve been lucky to work on different pieces of healthcare. I was in the Obama Administration working on policy, and I think if you can move policy in the right direction by even a degree, the positive impacts are huge. But I was also in clinical practice as a practicing doctor, I do academic work, and the innovation of excellence is what I do now. Any transformation I could help bring about would tie all of those pieces together. What makes me passionate about where I am right now is using multiple levers to push the needle.

Introducing the Next 10 Hive 2014 Startups

You’ve met 41 of the Hive 2014 startups so far. Today we introduce 10 more who will join us live this September 10-12 in Washington, DC, and San Francisco, CA, as we bring the world together to celebrate innovation and progress in health and medicine. Mobile devices, sensors, and apps will play a huge role in healthcare delivery, and many of these Hive inductees are leveraging those technologies in genius new ways. Read all about them here.


ActiveProtective created clothing and wearable devices that help protect wearers from injury through sensors that can detect falls or rapid motion and deploy micro-airbags.


BeneVir Biopharm is designing a cancer therapeutic that could benefit a wide range of cancer patients by inducing the immune system to recognize and rid the body of two types of tumor cells.


Clear Guide Medical has created next-generation ultrasound guidance for needle-based procedures that makes hitting the target as simple as playing a video game.


Infield Health marries custom patient data analytics and optimal care protocols to help patients use their mobile phones to adhere to care plans before and after hospital procedures.


Klappo is a platform that enables the development of apps to help people make educated choices about the food and ingredients they consume.


Maxwell Health provides a paperless, mobile-enabled operating system to dramatically simplify and streamline enrollment and management of employee benefits.


MessageDoc provides a secure and easy-to-use communication system to save providers time and money, improves relationships between practices, increases patient engagement, and helps avoid repeat visits.


Possible is pioneering an approach that integrates the best of private, public, and philanthropic models to deliver high-quality, low-cost healthcare to the world’s poor.


Remedy’s secure, HIPAA-compliant platform leverages Google Glass to enable remote experts to see through the eyes of on-site physicians and weigh in on procedures, treatment plans, or diagnoses.


TedCas has created an operating-system-agnostic way to enable surgeons to control any computer in the operating room via gestures and voice commands. It’s touch-less technology for healthcare.

Plus, check out the latest Hive Curator interview on the TEDMED Blog this week, featuring the Philips Healthcare Chief Design Officer Sean Hughes, who leads a global design team that is developing a broad range of word class products, interfaces, and consulting solutions to shape the future of healthcare and save lives. Read more here.

Eleven more Hive companies to be unveiled next week. Stay tuned @TEDMED.

– The TEDMED Team

To Address the Continuum of Care? Collaborate

SeanHughesAs Chief Design Officer at Philips Healthcare, Sean Hughes leads the global design team, developing a broad range of world class products, interfaces, and consulting solutions to shape the future of healthcare and save lives. Over a 20+ year career across 3 continents and multiple business categories, he has built and led multidisciplinary award-winning design teams that deliver business results while maximizing the role of design as a key element of sustainable competitive advantage.

TEDMED: What’s the most remarkable innovation you are seeing in health tech or medicine, and what is driving it? 

Hughes: There are a number of remarkable things happening in the health industry. One of the most fundamental ones is the rise and the breadth of digital technologies—from telecommunications, to Wi-Fi, to Bluetooth, to near field communication, to data aggregation—that are having a significant impact in healthcare and medicine. The fact that we can gather, communicate, analyze, and measure data is allowing us to think about how we might deliver care in very different way.

Another remarkable innovation for medicine is social media. The power of social media brings communities of patients and professionals together and provides them with the openness and ability to communicate. Patients are empowered now, coming to the table with their own diagnoses.

The new ways we can interact with technology is also having an impact on what we think we can do. These new interaction paradigms include very easily touch-controlled devices, voices becoming a way to navigate and better communicate, gesture control—which is the next thing in gaming, but is a way to track medical devices—and wearable technology, including smart, discrete sensors that you put in and around your body to monitor your health, lifestyle, and sleep. All of those can impact how we treat, diagnose, and care for people.

Driving all of this innovation in part are the challenges the industry is facing to deliver more care to more people at lower cost.

TEDMED: What’s the most important factor for entrepreneurial success in health tech—and is that different from your own key to success?

Hughes: What I saw in many of the Hive applicants, and what I believe is crucial to being successful, is a lot of passion and an enormous degree of self belief. Passion entails believing in your ideas and having the energy to continually push. Generally, if you’re innovating, you’re pushing against the current. In some cases it’s going to be disruptive and you have to challenge the status quo. You need a good degree of belief to convince others that this new or different way of doing things or looking at things is worthwhile so people will change their mind and follow you.

Timing is also really important. You can have a great idea, but you might be just a little bit early or ahead of the adoption curve and it will flounder. One or two years later, some other factors come to bear and you can have a massive hit.

Entrepreneurship is also about experimentation. Most successful entrepreneurs don’t often have the success with their first product or business. They’ve continued to evolve and push and it’s maybe the second or third time when they really hit the home run. Entrepreneurship is about active experimentation, risk, trial, and perseverance.

Finally, underneath it all, successful entrepreneurs possess an understanding of the market or the people they’re trying to reach.

Personally, I have a passion and desire to make a difference and that’s what I’m trying to do—to use design capabilities to help us deliver better healthcare. We passionately believe in that at Philips, which is why we’re working hard every day to create the future of healthcare.

TEDMED: For entrepreneurs with needle-moving ideas in global health, what are the keys to finding collaborators and supporters across specialties, industries, and geographies?  

Hughes: Networking, networking, networking. Increasingly, the world of healthcare is an incredibly complex networked ecosystem, and you have to be actively engaged within and open to working across that network. Of course, companies who are part of or applying to be in the Hive are taking one step in that direction, and many of them had already presented their ideas in other forums before TEDMED.

In the past, maybe life was simpler. At Philips, we made equipment, sold equipment, put it into service, and gave a service contract. That paradigm has changed. Our customers are asking us to do more, we want to do more, and we believe we can add more value by moving up the value chain, including by delivering services, offering solutions, taking some of our customers’ problems away, providing care outside of the hospital, moving care into the home, and transforming how care is delivered.

But we can’t do that on our own. We need to be active in that network with new partners, governments, local authorities, startup tech companies, or whoever it might be. And we can leverage our local network to help nurture smaller companies that collaborate with us. The era of open innovation is really upon us. Because of our global reach, scale, and R&D expertise, companies like Philips have a very active role to play in collaborating with smaller and more nimble companies to provide better healthcare solutions. We don’t have all the good ideas at Philips; we’re open to working with others who have good ideas. 

TEDMED: In 2020, you’re asked to give a TEDMED talk about the biggest transformation you helped bring about in your field. What is it?

Hughes: At Philips, we set ourselves a target to touch 3 billion lives per annum by 2025. That’s an audited number, not just made up, and it’s about us having a positive impact on the world. At Philips we talk about bringing innovation to you, and that’s how we’re going to measure that. We should be well on our way to achieving that by 2020.

Dreaming about what I’d say to that TEDMED audience in Washington in 2020 about what I have achieved as the chief design officer for Philips Healthcare, I’d like to be able to say we’ve been a leader in the digital transformation of care; we’ve brought care to more places and to more people; and we have a portfolio of solutions and offers across the continuum of care that help you through your healthcare journey of life, in wellness as well as clinical intervention. And we’d be able to pat ourselves on the back and say that we’ve delivered what our brand is all about, which is bringing innovation to you, the end user.

Live Online Event: How does poverty affect health decisions?

Poverty affects every aspect of life and has particularly bad repercussions on human health. The stress of poverty has detrimental effects on the body — and especially the brain.

Two landmark studies are among the many to show poverty’s harsh impact. In the Whitehall Studies, researchers at the University College of London sought to understand how the health of men in the British Civil Service varied by rank. Published in 1978, the first study showed that men ranking lowest were nearly four times more likely to have their lives abruptly ended by heart disease than those at the top. More recently, economist Barry Bosworth at the Brookings Institute and Kathleen Burke of the Consumer Financial Protection Bureau published a study in April 2014 about the life expectancy of women in their mid-fifties with similarly morbid results. A woman at the top of the income scale could expect to live an entire decade longer than a woman of the same age at the lower end.

Obvious reasons exist for health problems among the poor. Physician shortages in low-income neighborhoods leave individuals in these areas with hard options. The closest primary care physician may be over an hour’s ride away on public transportation, which makes it financially taxing and time consuming to make prescribed visits. Beyond the health care system, individuals living below the poverty line are usually overworked, sleep deprived, not able to afford healthy food, and constantly exposed to less than adequate living conditions. The list goes on.

shutterstock_177309557Scientists have begun to discover that poverty takes its toll on health starting at an early age. A recent study published in Nature pointed to telomeres, which are the caps on the end of chromosomes. The research showed that children who grew up in low-income families had shorter telomeres than their peers from more wealthy families. While telomere length naturally reduces with aging, premature shortening of telomeres can lead to a shortened lifespan, as well as an increased risk of chronic disease.

Poverty May Affect Cognitive Function

This host of daily problems also causes toxic stress that doesn’t just target the immune system; it influences almost every aspect of the body, including the brain.
“Studies show chronic stress can change the chemical and physical structures of the brain,” Annie Gilbertson explains in her recent article, “Teaching Through Trauma.”
These changes can be linked to impairments in attention, concentration, memory, and cognition.

One haunting finding is that damage can be done before a child is even born. Psychological and physiological mechanisms activated in response to the stress of poverty send signals to a developing fetus about this environment. According to a 2012 study published in The Journal of American Academy of Pediatrics, stress-induced changes in brain architecture that occur in utero “have potentially permanent effects on a range of important functions, such as regulating stress physiology, learning new skills, and developing the capacity to make healthy adaptations to future adversity.”

With such cognitive disadvantages from the start, it’s no wonder that those in poverty don’t always make health conscious decisions. Johannes Haushofer and Ernst Fehr examined decision-making skills of individuals living below the poverty line in their recent research On the Psychology of Poverty. They found that individuals who are financially constrained favor short-term over long-term benefits when making decisions. This type of thinking is what drives a person with persistent chest pain to self-medicate in lieu of visiting a doctor, or to invest their paycheck in a tv instead of gym membership.


Intervening in the Cycle of Poverty

Does poverty automatically lead to a hopeless health outcome? A number of community-based interventions hope to turn the prognosis around. For example, some schools that serve low-income students have been looking for ways to support students and their families inside and outside of the classroom. These efforts include counseling for kids who have been through a traumatic experience or are battling a mental health issue, tutoring for students who are struggling with academics, and helping parents find healthcare providers. Other organizations cater to the needs of low-income areas by offering a one-stop-shop sort of clinic that not only offers basic medical care, but also groceries, eyeglasses, and clothing.

With more inclusive and accessible healthcare options, there is hope that some of the health problems caused by poverty will be abated.

Scientists are also making efforts to find the best way to help reverse or eradicate poverty’s health effects. Could education about basic health and nutrition for low-income populations help? Could cash transfers improve some of the health problems that result from poverty?

poverty hangout

To learn more about psychology of poverty and which interventions work best to thwart the cycle, join a live online event. Participants include:

Joe Rojas-Burke (moderator): Independent Journalist and Author of “The challenge of writing about people in poverty
James Redford: Director of Paper Tigers
Laura Gottlieb, MD, MPH: Center for Health and Community at UCSF
Johannes Haushofer: Postdoctorate at MIT’s Abdul Latif Jameel Poverty Action Lab
Teri Barila and Mark Brown: Children’s Resilience Initiative

By: Lydia Marks