As a child, the United States Surgeon General Jerome Adams, MD, MPH, suffered from asthma so severe that he spent months at a time in the hospital, even once being airlifted to a children’s hospital in Washington, D.C. During these stays, he was struck by the fact that he’d never encountered a black physician. That finally changed when as an undergraduate he met a prominent African-American doctor who had overcome his own significant life obstacles. Seeing another African-American making important contributions to the field of medicine inspired the young Jerome Adams to decide, “I can do that too.”
With that resolve, he embarked on a path that led to becoming an anesthesiologist and culminated in his appointment as the nation’s 20th surgeon general.
Reflecting on his journey, Dr. Adams notes, “that’s why the efforts at the Robert Wood Johnson Foundation (RWJF) are so important. You’re providing mentorship and leadership opportunities to those who wouldn’t otherwise know how to navigate the world of public health.”
He shared these words during a visit to the Foundation where he discussed his role in building a Culture of Health with RWJF CEO Rich Besser. The conversation covered a range of issues in which Dr. Adams repeatedly stressed the role of partnerships in building healthier, resilient communities and addressing challenges such as the nation’s opioid epidemic. Here are a few takeaways from their conversation.
Intervene upstream to address the nation’s opioid epidemic.
Dr. Adams is open about his younger brother Phillip’s struggles with substance abuse. He had taken his 12- and 13-year-old sons to visit their uncle, who is currently spending 10 years in a Maryland state prison for stealing $200 to support his addiction. Phillip shared with his nephews that he suffered from untreated depression while in high school which led to self-medicating with alcohol, marijuana, and eventually other substances before he began committing crimes to support his habit.
“What’s most frustrating to me is that despite being a doctor, I couldn’t intervene alone. None of us can face this alone,” said Dr. Adams, noting that addiction touches everyone regardless of their race, sex, age, socioeconomic status or where they live.
“We need to understand that this is a complicated problem influenced by a variety of upstream factors, including childhood trauma and community resilience. The most cost-effective and humane way to address the opioid epidemic is through prevention and partnerships. For example, since local law enforcement is the number one touch point for connecting people struggling with addiction to mental health support services, we need to partner with them and help them understand their role in connecting people to the care they need.”
Dr. Adams believes in upstream interventions that address underlying risk factors such as adverse childhood experiences (ACES) which increase the risk for addiction. He also believes in shifting away from criminalizing addicts and instead, providing treatment options to support their long-term recovery.
The power of partnerships is key to building a Culture of Health.
Dr. Adams noted the importance of engaging non-traditional partners to create healthier communities, sharing his mantra “better health through better partnerships.”
“Local conversations and finding common ground is key to building a Culture of Health. We need to consider the roles of business, education, faith, and law enforcement in building healthier communities. I also challenge everyone to consider who else is not at the table that should be and reach out to them.”
He highlighted the role of the business sector in addressing workforce shortages, absenteeism, and productivity. While the businesses may view workplace health as an insurance expense, there is a larger role for them to play in instituting workplace wellness programs and by influencing policy at the community level. “We need to create a Culture of Health in all sectors. Businesses can play an important role in lifting up the health of their communities. By doing so, they can see better health, better productivity, and better return on investments.”
He also reflected on the partnership he formed with law enforcement during his tenure as Indiana’s state health commissioner. At the time, Scott County, Ind., was facing an unprecedented spread of HIV among intravenous drug users. Through his collaboration with law enforcement, Dr. Adams was able to institute an evidence-based syringe service program in one of the most conservative areas within Indiana. Doing so halted the spread of HIV in the community.
Frame issues so others understand their role in building a Culture of Health.
There’s tremendous opportunity in framing issues to help people understand their role in prevention, as well as health equity, according to Dr. Adams. “When I talk about health equity I mention veterans, those with disabilities, and people in rural areas,” he said. “Showing others how everyone benefits from addressing inequities is more effective than using moral arguments.”
Another example Dr. Adams shared to illustrate this was noting how overworked teachers may feel burdened by having to promote a variety of programs including healthy eating and physical fitness. The fact that teachers are evaluated and paid based on test scores can be the bridge to compel them to advocate for students’ physical activity. “If we tell them we have a physical fitness program to help get test scores up, they listen.” Such an intervention was implemented in an Indiana community while he was health commissioner. When teachers witnessed the positive results, they scrambled for access to exercise rooms before their students took exams.
“It shows how we need to frame issues to help people understand how supporting health can help them achieve their goals—versus expecting them to see things from our point of view. We need to use language that resonates with those we’re talking to in order to gain their support.”
Read more on RWJF.org.