Great Challenges: Conversations Continue

The top 20 Great Challenges were announced yesterday. Perhaps one of the most exciting things to come out of the Great Challenges program, sponsored by the Robert Wood Johnson Foundation, was the amazing conversations that these topics catalyzed. Below are highlights from conversations with advocates for some of the top 20 Challenges.

Suzanne Geffen Mintz, National Family Caregivers Association, and Lincoln Smith, President and CEO of Altarum Institute

“Patients themselves might not have the capacity to engage in their own care,” said Lincoln Smith, President of the Altarum Institute. “It’s draining.” Challenge #34, The Caregiver Crisis, came out second in the list of top 20 Great Challenges. The bad news is that health outcomes may be worse for caregivers because of the time, financial and stress burdens they face. Suzanne Geffen Mintz, National Family Caregivers Association Co-founder and advocate for Challenge #34, said what she wants most as a caregiver herself is for someone to, “document what we do. We’re like illegal aliens. We need to be in medical records — both in the patient’s records and in our own.”

This would help identify who needs support and resources, and help to connect them with what they need. Businesses lose billions of dollars in productivity due to caregiver struggles, said Geffen Mintz, and that’s because, “It impacts every sector of society and no family is immune.”

Christine Ferguson, Challenge Advocate, with newfound TEDMED friends Marty Kearns and Patrick McCrummen

Challenge #2 brings attention to another pervasive problem at crisis levels, Coming to Terms with the Obesity Crisis. “It’s interesting,” said Christine Ferguson, JD, Director of the STOP Obesity Alliance and Challenge #2 advocate, “when we have cancer affecting around 8% of the population, diabetes around 10% and obesity 35% — what has preventing us from addressing it?” Barriers include the perception that the problem is too complicated, or that it’s just a matter of willpower, she said. The “pull yourself up by the bootstraps” mentality that used to exist for mental health issues too, needs to go away before we can truly make progress, said Ferguson. She quoted some startling statistics — over 70% of obese people know all of the relevant health messages such as portion size, and have tried to change at least once; while 70% of primary care providers say no one in their office had any training on helping overweight and obese people get healthier. People are motivated and trying, but they don’t have the resources or support for change.

Marty Kearns, Project Director of, a project of the Robert Wood Johnson Foundation, said his organization is working to change policies and environments to help children and families eat well and move more, and by fostering, engaging and connecting a base of advocates who are willing to take action. Partick McCrummen, Senior Director for Corporate Contributions at Johnson & Johnson, also talked about the value of collaboration, and said J&J is hoping to serve as a convener for thought leaders and global organizations.

As we’re working so hard to improve the health of the world, what’s the one thing we’re all forgetting? “It’s the secret health crisis that’s right in front of our face,” said Russell Sanna, PhD, Executive Director of Harvard Medical School Division of Sleep Medicine and advocate for surprise add, Challenge #51. The big culprit? Sleep. We all know we need it, and none of us get enough. Why not? “There is an uncoordinated conspiracy against sleep health,” said Sanna. Feeding the conspiracy are Facebook, mobile phones, entertainment, an over-achieving society and pervasive sleep illiteracy. Embarrassingly, Sanna quickly uncovered this reporter’s own sleep illiteracy — sleep bulimia (“I’ll catch up on sleep this weekend”) doesn’t work? The color blue triggers your circadian rhythm (think Facebook), keeping you up when you should be winding down?

“There’s hope,” said Sanna. NBA stars are now hiring sleep consultants to ensure better performance despite hectic schedules (sound familiar?). Sanna hopes this is the start of a massive culture shift that will no longer encourage or allow bad sleep habits. Possible solutions: encourage employers to trigger a “go-dark” period on company Blackberries, and Facebook to turn its blue background grey at a user-specified hour as a reminder to shut down and get some sleep.

But every solution won’t necessarily work for every person. “Each individual has different health risks,” said Rebecca Sutphen, President and Chief Medical Officer of InformedDNA and advocate for Challenge #4, Shaping the Future of Personalized Medicine. “The genome is the key to paying attention to the right things,” said Sutphen, who urged us as a society to move medicine forward by unlocking the solutions that lie within our own bodies.

We spoke with many more advocates and overheard some fascinating conversations. Stay tuned for more on the 20 Great Challenges throughout the year.