With many young people deciding that the city, once again, is their destination of choice, we wanted to find out whether urban planning today is meeting the needs of this generation. Generations past gave us public water and sanitation, zoning, building codes and roadways that did more to influence our health and well being than medical care. So what about today’s designers? The development of every aspect of the urban landscape–from streets and sidewalks to green spaces, mass transit and housing–fundamentally influences the health and safety of the people who live there. Following on to out previous podcast on the social determinants of health, we take a look at the impacts of the built environment on all aspects of our life and ways in which those who can best design these spaces are often not involved. In the book ‘Changing Places’ John MacDonald, Robert Stokes and our guest, Charles Branas urge us to look anew at the disconnect between those who implement place-based changes, such as planners and developers, and the urban scientists who are now able to rigorously evaluate these changes on how we live. In doing so, we paint the broad picture of what is needed to improve outcomes for those of all socioeconomic backgrounds sharing an urban space. Hot button issues like gentrification, open space, transportation and street environments as well as recreation opportunities are touched upon.

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Many of us think that our genes and our lifestyle, or just plain luck, determine our health outcomes. As a society, we’re beginning to understand another key factor is the growing impact of the social determinants of health–the walk ability of our neighborhood, access to medical facilities and transportation, living in areas that aren’t environmentally compromised and having access to fresh foods. Never has this become clearer than in recent weeks as we have seen more African-American citizens succumb to the deadly coronavirus. While policymakers say they want to study and address this issue, this podcast offers important information on these social determinants of your well being. While some of us take access to health care, quality foods and environmentally unspoiled conditions for granted, for a large swath of the population, these critical concerns are real and a daily obstacle to good health. Scott McPhee, DrPH(Doctor of Public Health) and Bay Path University’s program coordinator in the Master of Public Health program, walks us through the role that public health has played in addressing issues from HIV to cancer to opioid abuse. And while Americans like to think we can control our own health destiny, he brings perspective to the differences between our personal clinical health and the effects that public health issues have on how those services are distributed and available to all. So, as much as you are ‘what you eat’, in many cases you also are ‘where you live’.

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So many vulnerabilities become more visible and are exacerbated during a crisis, like the coronavirus pandemic. In America, we’ve seen how quickly economic prosperity can be undone and inequities in the system revealed. We also see how lack of attention to public health, except in a crisis, makes the world’s most capable nation look wholly unprepared. One of the most glaring reveals is how America has ceded to China its drug making capabilities. You can well imagine shortages looming for staples like penicillin and antibiotics as we have outsourced those drugs to, what at best can be described as, an economic competitor. At worst, a malign one which is turning into an adversary. Rosemary Gibson, of The Hastings Center, is the thought leader in this country, who spent years uncovering this little known story for her book “China Rx: Exposing the Risks of America’s Dependence on China’. She sounds the alarm in this podcast so that you know what a shortcoming it is to let unfair trade practices impinge on the healthcare needs of our citizens. And how we must restore drug manufacturing capabilities to our shores–and fast. It’s a matter of quantity and quality and demands your attention. Few issues rise to the level of life or death as this one does.

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Much has been, and will be, written about government’s delays in containing the deadly COVID-19 corona virus. We hear the names CDC, FDA, HHS and a tangle of bureaucracies named during the Administration’s daily briefings. To what extent did the many regulations governing the actions of each layer of government play a role in delaying a timely response to testing, procurement and a host of other issues? The testing delays were, perhaps, most troubling and costly as public health officials across the country were prevented from using their own tests, buying them overseas, or using local labs. Philip K. Howard and founder of the non-profit organization, Common Good, has been writing about the need for sensible and smart regulation which provides for human judgment to override reams of written rules. He feels that this crisis has exposed the dangers of relying too heavily on hidebound regulations in the face of fast moving events. Think about it. In the span of a few weeks, governors designed their own testing regimes, loosened restrictions on telemedicine and occupational licensing was waived to allow medical professionals to come across state lines to meet the surge head on. He also argues for a Recovery Authority as the public health emergency recedes so that getting American business up and running can occur with more pace. For an example, restaurants are the lifeblood of New York City. Many have shut down. New ones will emerge. Starting a restaurant in the City requires permits from upward of eleven agencies. Really? Will streamlining of archaic rules allow commerce to return more quickly? And will changes to medical regulation in a crisis lead to more permanent changes? We’ll discuss on today’s episode.

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The baby boomers liked their suburban homes, with lots of room inside and out. The millennials, many of whom will be relied upon to buy them, not so much. Between now and 2037 it is projected that 21 million homes will hit the market as boomers downsize, move in with family and require assisted living situations. That will put a lot of downward pressure on the housing market as young people want to smaller, more urban-like and transit friendly environments. So, what happens to these homes? That’s a big part of the conversation we have with Tara Mastroeni who writes about real estate for Forbes, Realtor.com and others. We also discuss the new I Buying approach to making the real estate experience more seamless and less splintered. It rolls up buying and selling your home, as well as title and home insurance and the move, too, into one package. These algorithm-powered home flipping platforms suggest a huge change in the way we do real estate business going forward as giants like Zillow and Keller-Williams adjust their business models to accommodate.

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  At our founding, there were very distinctive regional flavors that made up the American palate.  Over time, as part of the industrial revolution, Americans began to standardize the way foods were prepared, thus saving time and assuring us that a trusted brand stood behind what we were consuming.  Today, in a trend that has been in the making for decades, Americans are demanding tastier, fresher and more organic foods.  In his remarkable book ‘American Cuisine’, historian Paul Freedman explains the changing nature of food and diet in our culture.  Yes, of course, we talk about our propensity to eat fast and consume fast foods. And how various immigrants to our country have maintained their traditions or cast them aside.  However, his take on where our food choices originated and where the are headed is a fascinating romp that includes discussion of today’s restaurant experience, food trucks, diners and the economics of food in America.  And we touch on the impact of social media and food television on our gastronomical choices.  Cuisine choices explains a lot about a culture.  If you want to better understand ours, listen to this episode.

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Have you ever stopped to read all the fees tacked on to your electric bill, cable bill, mortgage, car or student loan?  It’s a cut by a thousand fees–$1.47 here, $2.50 there and before you know it, it adds up to real money.  In fact, it’s over a trillion and a half dollars a year to consumers.  In combination, financial deregulation and wage stagnation have thrown us into the arms of unscrupulous lenders who have helped write legislation and regulations allowing these practices to continue with little transparency.  Add to this the fact that governments at every level have employed their own chicanery to extract new revenues by adding fees and fines, which are little noticed or objected to, in lieu of increasing your taxes.  In fact, the largest growth in government finances in the recent period has come from these charges.  Devin Fergus, Ph.D., in his compelling new book ‘Land of the Fee’ explains how these fees have become an added cost to all of life’s essentials and a little acknowledged reason for the decline of the middle class and income inequality.  In fact, the cumulative effect can have lifetime and intergenerational consequences.  

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  At a recent gathering of the leaders of the world’s democracies in Canada, the reporting from the meeting in Politico opened with the sentence: ‘if there’s a word that sums up the current mood of the West’s high command, it’s this: despair’.  On the heels of French President Emmanuel Macron suggesting that NATO leadership was ‘brain dead’, we wanted to talk these concerns over with Ivan Eland, Senior Fellow at the Independent Institute and Director of their Center on Peace and Liberty.  He spent fifteen years working for Congress on national security issues and his most recent book is ‘War and the Rogue Presidency’. We looked at the findings of Freedom House which recorded in their most recent report on Freedom in the World that for the 13th consecutive year there is a decline in global freedom.  The discussion started there and then began to highlight hot spots and vulnerabilities of the United States and other democracies as they react to fractious politics at home, and demands from many to disengage from the world as a nationalistic fervor has taken hold in many places.  The health of alliances and the rise of China and Russia to fill vacuums being left by Western democracies are growing concerns.  It’s an uncertain time with internal issues occupying many leaders who might otherwise play a greater world on the international stage.  It’s a sobering reality that we address here.

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In the realm of groundbreaking work, David Kessler and Elizabeth Kubler-Ross introduced us to the five stages of grief: denial, anger, bargaining, depression and acceptance in 2005 in the book ‘On Grief and Grieving’. Ms. Kubler-Ross has died, but Mr. Kessler, the world’s most well-known expert on grieving, continues his work and introduces us to the sixth stage of grief in his new book, ‘Finding Meaning’.  He reminds us in this podcast that grieving is a journey that contours in different ways for each person and that you cannot put each stage in a neat box.  It’s messy. He further illuminates the essential nature of ‘meaning’ which allows you to sustain your love for the person after their death while also moving forward with yours.  It’s one of those conversations you just want to listen in on as the realities of grief will visit us all.  He offers a free on-line class with this book and describes that in this discussion.

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  It’s hard to drive past any fast food chain restaurant without noticing that places known for unhealthy choices have added one item that most nutritionists say is better than those historically offered.  It’s the plant-based, or meatless, burger.  So we decided to find out if this new food craze is really as good as advertised.  And the story, like most, is more complex than meets the eye. If you’re using it to replace other vegetables and fruit in your diet or coupling it with French fries, lots of toppings and a sugary drink, then you’re defeating the purpose. After all, it is a ‘processed food’.  In the podcast, we’ll rummage around to find a definition for that term.  We’ll also assess whether this is a food breakthrough or a fad and whether it’s key benefit may be weaning us off beef options for the betterment of our health and our planet.  We call upon Debbie Petitpain, a spokesperson and registered dietitian affiliated with the Academy of Nutrition and Dietetics, to provide answers and she delivers big time.  And while meatless meat is going mainstream, it’s being met with a backlash from various sources.  We’ll try to objectively tackles those, as well.

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