WEBVTT 00:00.230 --> 00:01.860 - I hope everybody got a chance to stretch, 00:01.860 --> 00:03.683 we've got one last panel. 00:05.460 --> 00:08.089 And then you'll be able to 00:08.089 --> 00:11.172 (audience murmuring) 00:12.320 --> 00:13.160 go home. 00:13.160 --> 00:15.040 (chuckling) 00:15.040 --> 00:16.754 All right, everyone. 00:16.754 --> 00:17.908 - It's the arrow. 00:17.908 --> 00:19.187 - It's not working, Patty. 00:19.187 --> 00:20.490 - It's not, okay. 00:20.490 --> 00:22.483 Well we'll just ask about. 00:25.400 --> 00:27.578 All right everybody, thank you so much. 00:27.578 --> 00:30.540 Alana, when you get a chance, 00:30.540 --> 00:32.320 we're trying to use the pointer 00:32.320 --> 00:33.660 and it's not working? 00:33.660 --> 00:35.033 The clicker, sorry. 00:40.940 --> 00:41.773 Perfect. 00:41.773 --> 00:42.763 - [Female] Wait, I went too far. 00:42.763 --> 00:46.810 - Okay, so, as we're working with that, for just a second, 00:46.810 --> 00:50.910 I'm gonna go ahead and introduce our panel moderator 00:50.910 --> 00:52.607 who told me, "Don't say too much about me, 00:52.607 --> 00:53.587 "'cause this isn't about me, 00:53.587 --> 00:55.740 "this is about all this great information." 00:55.740 --> 00:57.150 But she is pretty amazing, 00:57.150 --> 00:58.750 so it's my pleasure to introduce 00:58.750 --> 01:00.330 the moderator for our last panel, 01:00.330 --> 01:01.810 Miss Laura Mitvalsky, 01:01.810 --> 01:05.400 who is the Director of Health Promotion and Wellness 01:05.400 --> 01:07.800 at the Army Public Health Center. 01:07.800 --> 01:09.410 This is a very important center, 01:09.410 --> 01:11.304 so I'm really excited that she's here. 01:11.304 --> 01:12.677 Laura. 01:12.677 --> 01:14.090 - Thank you, Patty. 01:14.090 --> 01:17.560 Well, hello distinguished military and civilian leaders 01:17.560 --> 01:20.660 and distinguished family member leaders. 01:20.660 --> 01:23.720 We're really excited to be able to provide you 01:23.720 --> 01:26.010 some information about things that you told us 01:26.010 --> 01:28.240 last year that you wanted to know, 01:28.240 --> 01:29.820 concerns that you had, 01:29.820 --> 01:33.910 and so this distinguished panel here is going to 01:33.910 --> 01:35.530 tell you a little bit about what we've learned 01:35.530 --> 01:36.730 in this last year. 01:36.730 --> 01:37.980 Let me put on my readers. 01:39.510 --> 01:40.500 Okay. 01:40.500 --> 01:41.853 Let's see if this works. 01:43.520 --> 01:45.000 And it doesn't. 01:45.000 --> 01:46.653 Next slide please. 01:53.340 --> 01:54.990 Great, thank you so much. 01:54.990 --> 01:57.000 So, we're really excited, 01:57.000 --> 01:58.120 I think I'm gonna tell you something 01:58.120 --> 02:01.100 that most of you in the audience already know, 02:01.100 --> 02:03.430 but it's a fact that's really important to be said 02:03.430 --> 02:07.190 before we actually get to what we want to talk to you about. 02:07.190 --> 02:09.370 So, the Army family is a huge group. 02:09.370 --> 02:11.890 This room is amazing. 02:11.890 --> 02:15.840 We have more family members than active duty soldiers. 02:15.840 --> 02:19.660 We have 675 thousand Army family members 02:19.660 --> 02:22.190 of our active duty soldiers today. 02:22.190 --> 02:23.710 So when you look at these slides 02:23.710 --> 02:27.020 that I have up here in front of you, 02:27.020 --> 02:29.750 if we kind of look at those numbers, 02:29.750 --> 02:32.510 60% of our active duty soldiers today 02:32.510 --> 02:35.582 have a spouse and/or children or dependents 02:35.582 --> 02:38.190 that are part of our Army family. 02:38.190 --> 02:41.590 And 61% of our soldiers are from families 02:41.590 --> 02:43.590 who have served in the military. 02:43.590 --> 02:45.230 So, we all know that, 02:45.230 --> 02:46.450 but when we wanted to have this 02:46.450 --> 02:49.180 panel today of healthy resilient families, 02:49.180 --> 02:50.870 there was a new bit of information 02:50.870 --> 02:53.020 that came from the office of People of Analytics, 02:53.020 --> 02:55.020 and if I can have the next slide please, 02:57.290 --> 02:58.930 that I think is pretty startling 02:58.930 --> 03:01.650 and really a call to action for all 03:01.650 --> 03:04.430 of those military leaders in the room. 03:04.430 --> 03:08.863 Spousal support is one of the top three predictors, 03:09.760 --> 03:11.910 biggest influences of a soldier's intentions 03:11.910 --> 03:13.260 to stay in the Army family. 03:13.260 --> 03:14.590 I don't know if anyone from 03:14.590 --> 03:16.980 Office of People Analytics is in the room 03:16.980 --> 03:19.520 but when we started to think about this panel 03:19.520 --> 03:21.500 and thinking about what we wanted to do about 03:21.500 --> 03:24.620 talking about optimizing the health of the Army family, 03:24.620 --> 03:28.120 we knew that more support from one's family 03:28.120 --> 03:31.920 is associated with the higher retention intention 03:31.920 --> 03:35.530 and actually higher actual retention. 03:35.530 --> 03:37.693 If I can hit these slide one more time, please. 03:37.693 --> 03:41.023 I don't know why I have these builds so thank you. 03:42.130 --> 03:44.240 When we look at this slide right here, 03:44.240 --> 03:47.410 93% of our service members in this 03:47.410 --> 03:49.509 Office of People Analytics study, 03:49.509 --> 03:52.710 93% of service members who's spouses 03:52.710 --> 03:56.470 strongly favor staying in the military 03:56.470 --> 03:59.360 that active duty family remains in the military. 03:59.360 --> 04:01.040 So, let's just say that one more time. 04:01.040 --> 04:04.860 93% of service members who's spouses 04:04.860 --> 04:08.860 strongly favors staying in the military, 04:08.860 --> 04:10.998 I see a face going up and down, 04:10.998 --> 04:14.650 that active duty soldier stays in the military. 04:14.650 --> 04:17.688 So, when you think about a readiness and retention issue, 04:17.688 --> 04:19.710 that's pretty phenomenal. 04:19.710 --> 04:23.570 So, in that second number there, 04:23.570 --> 04:26.040 oh you hit too fast but that's okay, 04:26.040 --> 04:27.470 I'll just tell you really quickly, 04:27.470 --> 04:29.390 we also know that when we ask spouses 04:29.390 --> 04:32.900 about 2/3 of Army spouses favor staying, 04:32.900 --> 04:35.010 and 20% favor leaving. 04:35.010 --> 04:37.990 Those aren't the strongly favor but they favor. 04:37.990 --> 04:39.860 So when we think about that 20%, 04:39.860 --> 04:42.600 we've got some work to ensure Army family 04:42.600 --> 04:44.680 is really supported and obviously that's what 04:44.680 --> 04:47.020 this whole discussion is about today. 04:47.020 --> 04:50.580 So bottom line, more support equals greater retention 04:50.580 --> 04:52.620 equals a ready and resilient force. 04:52.620 --> 04:57.030 And so what I'd like to talk about here quickly 04:57.030 --> 04:59.440 is that it takes a community, 04:59.440 --> 05:01.420 it takes everyone in this room, 05:01.420 --> 05:04.340 there's so many agencies in the room and online 05:04.340 --> 05:06.960 that support the Army family obviously 05:06.960 --> 05:08.300 and so when we think about the 05:08.300 --> 05:10.950 diverse groups at many levels working to 05:10.950 --> 05:13.280 improve the health of the Army family, 05:13.280 --> 05:17.250 external groups, Army organizations, Army communities, 05:17.250 --> 05:19.130 and the heart of this work obviously 05:19.130 --> 05:21.020 are Army family members. 05:21.020 --> 05:23.700 No single group can solve the issues facing 05:23.700 --> 05:25.980 the health and readiness of our soldiers today. 05:25.980 --> 05:27.200 It takes a team effort. 05:27.200 --> 05:29.540 And so this group today, this panel, 05:29.540 --> 05:31.110 who I'll introduce you to now 05:31.110 --> 05:33.570 are gonna tell you a little bit about that work. 05:33.570 --> 05:35.380 So, Mr. John Resta, to my left, 05:35.380 --> 05:37.800 is the Director of the Army Public Health Center. 05:37.800 --> 05:39.600 He always tells us that he is 05:39.600 --> 05:43.780 39 years and some months working for the government 05:43.780 --> 05:46.410 at the Army Public Health Center. 05:46.410 --> 05:50.440 He's a acting DCOS Public Health 05:50.440 --> 05:53.880 and as of today probably about three hours ago, 05:53.880 --> 05:56.428 he just had his first grandchild born. 05:56.428 --> 05:58.949 (audience cheering and clapping) 05:58.949 --> 06:00.220 Dylan. 06:00.220 --> 06:02.800 And although his wife Eileen is probably very mad at him, 06:02.800 --> 06:06.240 he is here because I said, "Please, please don't." 06:06.240 --> 06:08.550 so, he's gonna head out to Connecticut right, I guess, 06:08.550 --> 06:11.310 right after this panel. 06:11.310 --> 06:13.920 And then next to him is Mr. Tim Higdon. 06:13.920 --> 06:16.660 Tim is just a phenomenal leader at MCOMM. 06:16.660 --> 06:20.070 He's MCOMM G-9 family and MWR, 06:20.070 --> 06:23.030 and he's the lead for the Healthy Army Community's effort. 06:23.030 --> 06:25.030 And you're gonna be really excited to hear about 06:25.030 --> 06:27.324 what they're trying to do at your military installations 06:27.324 --> 06:30.790 to bring better health options for you 06:30.790 --> 06:32.610 on your military installations. 06:32.610 --> 06:36.380 And then next to Tim is Dr. Shelly MacDermid Wadsworth. 06:36.380 --> 06:38.530 She's from Purdue University and she's the 06:38.530 --> 06:42.760 Director of Military Family Research Initiative 06:42.760 --> 06:44.190 and is going to be sharing some 06:44.190 --> 06:46.000 really interesting information with you. 06:46.000 --> 06:49.400 And then finally, Ms. Elizabeth Groover, 06:49.400 --> 06:53.897 she's a professional spouse as all of you in this room, 06:53.897 --> 06:55.380 she has four children, 06:55.380 --> 06:57.230 she's moved numerous times, 06:57.230 --> 07:00.090 and just like any amazing Army family spouse, 07:00.090 --> 07:02.500 she was actually not our original panel member, 07:02.500 --> 07:05.800 so in your agenda you might see another name. 07:05.800 --> 07:08.317 We called her yesterday and she said, "Sure, I'll do it." 07:08.317 --> 07:10.670 And we could've probably pulled any of you up here, 07:10.670 --> 07:12.290 so we really appreciate Elizabeth. 07:12.290 --> 07:14.120 Her husband's at the 20th CBRNE 07:14.120 --> 07:17.340 up at Aberdeen Proving Ground. 07:17.340 --> 07:19.390 So, I'll turn it over to you, Mr. Resta 07:19.390 --> 07:21.090 and let you take it away. 07:21.090 --> 07:21.923 - Next slide. 07:21.923 --> 07:23.050 And I was actually south of the 07:23.050 --> 07:24.960 Harbor Tunnel when I found out, 07:24.960 --> 07:26.610 so I would've had to turn around. 07:27.450 --> 07:28.283 What I'd like to do, 07:28.283 --> 07:29.116 next slide please, 07:29.116 --> 07:32.770 is start with a story is about six or seven years ago 07:32.770 --> 07:34.850 I was asked a very simple question 07:34.850 --> 07:35.843 by my then boss at the time, 07:35.843 --> 07:38.070 Lieutenant General Horoho, 07:38.070 --> 07:40.070 what's the health of the force? 07:40.070 --> 07:43.127 And the first answer we gave her was 07:43.127 --> 07:46.287 "Well, it's complicated and it's difficult." 07:47.170 --> 07:49.380 And that wasn't good enough for her at the time. 07:49.380 --> 07:50.810 And so she wanted us to look at that. 07:50.810 --> 07:53.560 Well, luckily again, then I had somebody else 07:53.560 --> 07:55.650 that we were working with, Colonel Deydre Teyhen, 07:55.650 --> 07:57.170 who stood up earlier, 07:57.170 --> 07:59.270 who was saying, "Well, we can answer that question." 07:59.270 --> 08:02.760 And so we started down that process of trying to 08:02.760 --> 08:03.760 assess the health of the force. 08:03.760 --> 08:05.343 If I could next slide, please. 08:07.100 --> 08:09.690 Taking a look at what the health of the force is 08:09.690 --> 08:11.940 so that we can empower action. 08:11.940 --> 08:15.270 We know what illnesses and injuries we suffer from, 08:15.270 --> 08:18.330 we know what interventions work 08:18.330 --> 08:20.330 and we go forward and actually try 08:20.330 --> 08:23.170 and make the force a healthier place. 08:23.170 --> 08:26.020 Flash forward to about 2017, 08:26.020 --> 08:28.739 my boss at the time then Lieutenant General now retired 08:28.739 --> 08:31.710 Nadja West asked me, "Well, what about our families?" 08:31.710 --> 08:33.120 Next slide, please. 08:33.120 --> 08:37.140 And at that point I just assumed 21st century, 08:37.140 --> 08:39.760 we have a electronic health record, 08:39.760 --> 08:41.700 this is gonna be easy. 08:41.700 --> 08:44.730 Well, that's not actually true. 08:44.730 --> 08:47.410 Again, simple question, complicated answer. 08:47.410 --> 08:50.850 Everything we do within health is on a computer. 08:50.850 --> 08:53.080 The problem is it's not on a computer, 08:53.080 --> 08:56.470 it's on numerous computers, numerous databases. 08:56.470 --> 08:58.810 So, not everybody gets their healthcare 08:58.810 --> 09:01.630 within a military medical treatment facility, 09:01.630 --> 09:04.670 so we have multiple electronic health records. 09:04.670 --> 09:07.700 Not everybody has all their data 09:07.700 --> 09:10.590 about their children in the systems of record 09:10.590 --> 09:12.470 and by the way those systems of record 09:12.470 --> 09:14.710 are different than the medical records, 09:14.710 --> 09:16.410 and health is not really just an 09:16.410 --> 09:18.970 absence of sickness or injury, 09:18.970 --> 09:20.930 and it's not always represented fully 09:20.930 --> 09:23.020 within a medical record. 09:23.020 --> 09:25.940 So, we are embarking right now 09:25.940 --> 09:27.570 and what we have today for you 09:27.570 --> 09:29.936 is essentially version one of the 09:29.936 --> 09:31.380 Army Health of the Force 09:31.380 --> 09:32.640 and we'll go forward from there 09:32.640 --> 09:34.570 and get the version two, three and four 09:34.570 --> 09:36.280 and get it better as we go forward. 09:36.280 --> 09:37.453 So, next slide please. 09:39.030 --> 09:41.900 The first thing is that we started to look 09:41.900 --> 09:44.420 at about a year ago, you all read the news, 09:44.420 --> 09:46.100 you talked about it here at this record 09:46.100 --> 09:48.500 regarding blood lead levels in Army children 09:48.500 --> 09:50.950 or military children across the country. 09:50.950 --> 09:52.670 That caught us a little bit by surprise 09:52.670 --> 09:53.530 in the public health community 09:53.530 --> 09:55.360 because quite frankly we thought we had 09:55.360 --> 09:58.300 solved that problem in 1996. 09:58.300 --> 10:00.600 And to some extent we did, 10:00.600 --> 10:03.520 we just didn't solve it to our benefit. 10:03.520 --> 10:05.440 So, since that time we have been 10:05.440 --> 10:07.350 tracking this pretty closely 10:07.350 --> 10:09.720 and now we can tell you with some confidence 10:09.720 --> 10:11.870 that Army children have a risk of about 10:11.870 --> 10:14.850 five in a thousand to have an elevated blood lead level. 10:14.850 --> 10:18.595 That's about 1/5 to 1/4 the actual 10:18.595 --> 10:22.600 national averages depending upon where you live. 10:22.600 --> 10:24.900 Depending upon what data are in the system, 10:24.900 --> 10:29.430 it's sometimes about 1/10 of the national averages. 10:29.430 --> 10:30.500 That's still too high, 10:30.500 --> 10:31.570 it's too high for us, 10:31.570 --> 10:34.380 to high for me as a public health professional 10:34.380 --> 10:36.360 simply because this is the 21st century, 10:36.360 --> 10:40.260 we know that there are no safe levels of lead in blood. 10:40.260 --> 10:42.470 And so we're continuing to progress, 10:42.470 --> 10:44.140 we're continuing to look at that, 10:44.140 --> 10:46.060 and we're continuing to track this. 10:46.060 --> 10:49.160 We now actively manage each and every case 10:49.160 --> 10:51.450 of elevated blood life within the Army. 10:51.450 --> 10:55.110 First quarter of this year we've had 13 cases, 10:55.110 --> 10:58.620 I'm sorry 16 cases, 10:58.620 --> 11:00.880 2nd quarter we had 15 cases out of about 11:00.880 --> 11:04.020 31 hundred tests to date. 11:04.020 --> 11:06.580 So we're doing better there but we're not doing good enough. 11:06.580 --> 11:08.840 Our goal is actually zero cases, 11:08.840 --> 11:10.530 and we're working that now. 11:10.530 --> 11:11.810 If we have the next slide. 11:11.810 --> 11:15.108 We know that exposure to lead is not 11:15.108 --> 11:18.820 the only thing that we're worried about. 11:18.820 --> 11:20.220 So we're worried about it a lot of times 11:20.220 --> 11:21.940 vaccine preventable diseases, 11:21.940 --> 11:24.757 we're worried about exposure to lead in other areas. 11:24.757 --> 11:29.270 Now, 2013 we started looking at child youth services, 11:29.270 --> 11:32.590 child development centers in terms of drinking water. 11:32.590 --> 11:35.520 We have in partnership with MCOMM 11:35.520 --> 11:38.110 with what is now the Army G-9, 11:38.110 --> 11:41.640 we've looked at 100% of all facilities 11:41.640 --> 11:43.290 that serve children one lap, 11:43.290 --> 11:45.390 we're on our second lap now. 11:45.390 --> 11:47.880 And we've tested all the fountains, 11:47.880 --> 11:50.840 the sinks where they use it to make juices and the like, 11:50.840 --> 11:52.440 we've tested all those already 11:52.440 --> 11:55.500 and we're sitting there now we had about 4%, 11:55.500 --> 11:57.520 four out of a hundred, 11:57.520 --> 12:01.430 that had lead above the action level of 15 parts per bite, 12:01.430 --> 12:03.628 and in those cases those sinks, 12:03.628 --> 12:06.244 those drinking water fountains, 12:06.244 --> 12:08.850 that plumbing were replaced. 12:08.850 --> 12:10.170 And so we're in the process now of 12:10.170 --> 12:12.240 going around the world essentially, 12:12.240 --> 12:15.200 and checking to make sure that that's still happens. 12:15.200 --> 12:18.050 We've already looked at 100% of all Army owned 12:18.050 --> 12:21.110 and leased housing that is not RCI housing, 12:21.110 --> 12:24.010 now that's just Army owned and leased housing. 12:24.010 --> 12:27.620 We had about 14% of those facilities 12:27.620 --> 12:31.710 had faucets, sinks, some water supplies 12:31.710 --> 12:34.800 that exceeded the action level for lead 12:34.800 --> 12:38.800 and the Army's gone through and replaced those faucets. 12:38.800 --> 12:40.650 So we're catching up on that 12:40.650 --> 12:42.950 and we're going to start a partnership 12:42.950 --> 12:45.830 to start looking at the other Army housing as we go forward. 12:45.830 --> 12:48.870 So, right now we are leading the country in that regard 12:48.870 --> 12:51.840 because the nation does not require this just yet. 12:51.840 --> 12:54.102 There was just a recent regulation for schools. 12:54.102 --> 12:55.970 We're already on our second lap 12:55.970 --> 12:58.120 and we're in full compliance with that. 12:58.120 --> 13:00.480 We're also looking at things like PFOA, PFOS, 13:00.480 --> 13:02.120 I don't know if people have heard about that yet. 13:02.120 --> 13:03.950 We call that forever chemicals. 13:03.950 --> 13:06.680 We've looked at all Army systems. 13:06.680 --> 13:08.370 Right now we have 10 systems that exceed 13:08.370 --> 13:10.720 the lifetime health advisory for that 13:10.720 --> 13:14.130 and we've taken essentially the contaminated wells offline 13:14.130 --> 13:16.591 or put in granular activated carbon treatment systems 13:16.591 --> 13:18.150 across the board there. 13:18.150 --> 13:21.280 So, we're protecting essentially our sources already 13:21.280 --> 13:24.890 now while awaiting the nation to take additional action. 13:24.890 --> 13:25.793 Next slide please. 13:26.870 --> 13:27.703 As I talked about, 13:27.703 --> 13:31.120 one of the other things we do is we're sitting here 13:31.120 --> 13:32.800 and we're concerned about housing. 13:32.800 --> 13:34.574 So, what we did is establish a 13:34.574 --> 13:38.302 housing environmental health registry 13:38.302 --> 13:41.600 where anybody who has an issue 13:41.600 --> 13:44.440 associated with housing can call and register. 13:44.440 --> 13:47.067 I was troubled a little bit by earlier comments, 13:47.067 --> 13:49.670 "I'm on the Navy base and they won't help me." 13:49.670 --> 13:52.283 We take sailors, we take Marines, we take Airmen, 13:52.283 --> 13:54.300 we take Coast Guard men, 13:54.300 --> 13:56.130 we actually take civilians who will call 13:56.130 --> 14:00.483 and register their families and ask questions. 14:04.496 --> 14:08.925 As of last Friday we're now 263 families registered, 14:08.925 --> 14:11.150 122 reported concerns, 14:11.150 --> 14:13.140 mold, dampness, standing water, 14:13.140 --> 14:16.490 114 families have requested additional information, 14:16.490 --> 14:20.190 67 of those cases have already been completed. 14:20.190 --> 14:21.940 At the same time what we're doing is 14:21.940 --> 14:24.065 tracking exposure to mold. 14:24.065 --> 14:27.520 We've had 107 cases of contact 14:27.520 --> 14:29.540 with suspected exposure to mold found 14:29.540 --> 14:31.800 in the electronic health record to date. 14:31.800 --> 14:36.720 32 on post housing mold assessments were requested 14:36.720 --> 14:38.720 associated with that to determine what the 14:38.720 --> 14:41.280 source of that mold exposure was. 14:41.280 --> 14:42.860 45 of those assessments were 14:42.860 --> 14:44.890 recommended by a health care provider 14:44.890 --> 14:46.910 were already initiated on post housing. 14:46.910 --> 14:49.630 So, we're sitting there and working through this. 14:49.630 --> 14:53.170 This is part of an overall Army housing campaign 14:53.170 --> 14:55.330 that you'll hear more about tomorrow 14:55.330 --> 14:59.220 in Family Forum four, I think is the number. 14:59.220 --> 15:01.530 But you'll find out that the Army has already 15:01.530 --> 15:04.500 hired in excess of 100 additional people 15:04.500 --> 15:06.050 to look at our housing problems. 15:06.050 --> 15:06.950 Next slide please. 15:08.540 --> 15:10.870 Lastly, we're concerned about preventive health care. 15:10.870 --> 15:13.810 I talked about child development centers. 15:13.810 --> 15:16.212 One of the things that we're very serious about is 15:16.212 --> 15:18.190 if you're aware of there's currently 15:18.190 --> 15:19.980 a Measles epidemic in the United States, 15:19.980 --> 15:21.690 first time we've had a Measles epidemic 15:21.690 --> 15:25.720 in probably four decades, maybe five decades. 15:25.720 --> 15:27.370 We've looked at that problem associated 15:27.370 --> 15:28.810 with child development centers 15:28.810 --> 15:31.330 and the majority, the majority of almost all 15:31.330 --> 15:33.670 children that are enrolled in our 15:33.670 --> 15:36.360 child development centers are already immunized 15:36.360 --> 15:41.360 against Measles and other vaccine preventable diseases. 15:41.666 --> 15:44.160 We're in the process now of trying to track 15:44.160 --> 15:47.349 for those children who are not enrolled in our systems. 15:47.349 --> 15:49.150 One of the problems that I talked about is 15:49.150 --> 15:52.096 that those records are on a computer somewhere 15:52.096 --> 15:54.765 and they're just not in the same place 15:54.765 --> 15:57.200 where we would like to find them every time. 15:57.200 --> 15:59.010 So, we're in the process of trying to figure a way 15:59.010 --> 16:01.296 to reach deep into these records, pull it out 16:01.296 --> 16:05.256 and get a better access to care situation, 16:05.256 --> 16:08.720 sort of what General Place was talking about earlier. 16:08.720 --> 16:11.100 I'm confident given the fact that right now 16:11.100 --> 16:14.550 we have 90% of our children basically get 16:14.550 --> 16:17.280 all of their well baby checks that receive care 16:17.280 --> 16:18.370 in the military health system, 16:18.370 --> 16:20.180 which exceeds the national averages 16:20.180 --> 16:22.420 almost by a factor of two. 16:22.420 --> 16:24.878 And so just that mere fact of access to care 16:24.878 --> 16:26.950 means that our children are gonna end up 16:26.950 --> 16:29.220 having better access seeking medical care. 16:29.220 --> 16:30.540 Now, that does not guarantee 16:30.540 --> 16:31.620 that they will be healthier. 16:31.620 --> 16:35.540 Access to care is a metric but is not the sole metric. 16:35.540 --> 16:37.050 We have to start looking at other things 16:37.050 --> 16:39.330 and we'll talk about that as we go along 16:39.330 --> 16:41.980 in terms of other healthier communities. 16:41.980 --> 16:45.113 And with that, Tim. 16:46.400 --> 16:47.885 - So, before you go, Tim, 16:47.885 --> 16:48.800 thank you, Mr. Resta, 16:48.800 --> 16:50.538 I wanted to just bring your attention to 16:50.538 --> 16:54.930 on your tables what Mr. Resta was talking about, 16:54.930 --> 16:57.125 there's a lot of more information we found out 16:57.125 --> 17:00.125 in terms of optimizing the Health of the Army Family. 17:00.125 --> 17:01.860 The whole team at that table, 17:01.860 --> 17:02.840 raise your hand over there, 17:02.840 --> 17:05.170 Dr. Beamer, Dr. Santo, Dr. Jill Brown, 17:05.170 --> 17:07.820 all of them they were the ones working with 17:07.820 --> 17:10.280 I'm gonna say OACSIM because we all still know 17:10.280 --> 17:12.261 the headquarters G-9, 17:12.261 --> 17:16.640 Dorie, D, the whole team to be able to 17:16.640 --> 17:18.320 pull this information together for you 17:18.320 --> 17:21.080 so we put a quite thick report 17:21.080 --> 17:23.590 into a really nice infographic. 17:23.590 --> 17:25.340 And then in terms of the housing registry, 17:25.340 --> 17:27.840 I know Colonel Casto's who's here in the front 17:27.840 --> 17:30.160 is gonna be briefing that tomorrow at the Family Forum, 17:30.160 --> 17:34.300 but right over here to your left is more information 17:34.300 --> 17:35.820 and the cards with that number 17:35.820 --> 17:39.250 and how to access the housing registry. 17:39.250 --> 17:40.950 So that's just on this first table. 17:40.950 --> 17:43.550 So, okay, Mr. Higdon, I'll hand it over to you. 17:43.550 --> 17:44.383 - Great, thank you, Laura, 17:44.383 --> 17:45.930 and thank you everyone for being here today. 17:45.930 --> 17:48.960 I'm really excited about the next 45 minutes 17:48.960 --> 17:49.793 that I have with you, 17:49.793 --> 17:51.018 and hopefully it feels more like 10, 17:51.018 --> 17:52.821 (laughing) 17:52.821 --> 17:54.900 so we'll try to keep it at that. 17:54.900 --> 17:58.800 Hey, in over my 30 years of being either a soldier 17:58.800 --> 18:00.040 or a veteran, or a civilian, 18:00.040 --> 18:02.230 or in my case a spouse, a father, brother, 18:02.230 --> 18:03.557 uncle of a soldier, 18:03.557 --> 18:05.400 everything that I'm hearing today 18:05.400 --> 18:06.960 is just so encouraging about our 18:06.960 --> 18:08.590 Army family and what we do, 18:08.590 --> 18:09.757 and I'm so proud to be a part of it 18:09.757 --> 18:12.300 and proud to be in this journey with you 18:12.300 --> 18:13.133 as we go through this. 18:13.133 --> 18:14.500 So, again, thank you for being here today 18:14.500 --> 18:15.770 and being a part of that. 18:15.770 --> 18:18.030 And then for allowing us to come and share with you 18:18.030 --> 18:19.449 a little bit about what we're trying to do on our side 18:19.449 --> 18:22.090 to continue down that journey with you. 18:22.090 --> 18:23.870 So, today I have the honor and privilege 18:23.870 --> 18:27.200 to represent a very committed team of stakeholders 18:27.200 --> 18:30.320 that are willing to make improvements on our 18:30.320 --> 18:32.841 Army installations to make healthier choices easy 18:32.841 --> 18:34.740 and we're really excited about that 18:34.740 --> 18:35.750 so I'm gonna try and share that 18:35.750 --> 18:37.500 with you today the best that I can. 18:41.090 --> 18:42.440 So we have a very committed team of 18:42.440 --> 18:44.010 stakeholders over the last four years 18:44.010 --> 18:46.839 that have really focused on providing some emphasis 18:46.839 --> 18:49.710 and some focus on things that have already been done. 18:49.710 --> 18:51.495 Whether it's our Defense Commissary Agency, 18:51.495 --> 18:53.580 the Exchange, 18:53.580 --> 18:54.690 Army G-4 that has a 18:54.690 --> 18:56.180 Joint Culinary Center of Excellence 18:56.180 --> 18:57.290 and Army Sustainment Command 18:57.290 --> 18:59.170 that oversee our dining facilities, 18:59.170 --> 19:01.420 Army Public Health Center and then of course 19:01.420 --> 19:03.605 my own MCOMM G-9 family and MWR, 19:03.605 --> 19:06.608 who all together are collaboratively working together 19:06.608 --> 19:09.840 to make those improvements and to look at what we're doing, 19:09.840 --> 19:12.844 but not only that to challenge each other a little bit. 19:12.844 --> 19:15.410 There was a time when maybe we didn't 19:15.410 --> 19:17.160 work so well together as a team 19:17.160 --> 19:18.770 and we've acknowledged that and we've said, 19:18.770 --> 19:20.020 you know what, we've gotta change that, 19:20.020 --> 19:20.853 we've gotta come together, 19:20.853 --> 19:22.570 we've gotta collaborate 19:22.570 --> 19:23.940 and we gotta hold each other accountable 19:23.940 --> 19:25.730 a little bit to try to make these improvements. 19:25.730 --> 19:28.374 And so I'm excited for the leaders in these organizations 19:28.374 --> 19:30.077 that have stood together with me and said, 19:30.077 --> 19:31.557 "Hey, we can do something 19:31.557 --> 19:33.220 "and we're gonna make and effect change." 19:33.220 --> 19:35.430 And so, again, very proud of the team 19:35.430 --> 19:36.880 and all that they're doing. 19:36.880 --> 19:39.109 And again, it's about finding what's possible 19:39.109 --> 19:42.083 and putting that change into place. 19:44.240 --> 19:46.300 I think we all realize there are 19:46.300 --> 19:48.074 several challenges in our community, 19:48.074 --> 19:51.360 but inactivity and obesity is definitely one 19:51.360 --> 19:53.810 that's having an impact on our readiness capabilities 19:53.810 --> 19:56.440 and so that's really the driving force behind 19:56.440 --> 19:58.430 doing what we're doing and why we're doing it. 19:58.430 --> 20:01.110 We want to make those positive impacts and try to do that. 20:01.110 --> 20:03.900 So, we have a unified commitment under MCOMM's leadership 20:03.900 --> 20:06.335 through Healthy Army Communities to do just that. 20:06.335 --> 20:08.809 With a goal of making healthier choices easy, 20:08.809 --> 20:12.540 but also likely in everything and every day 20:12.540 --> 20:15.143 that you are on our Army garrisons. 20:19.840 --> 20:21.948 So, we're doing that by focusing on three key areas, 20:21.948 --> 20:23.500 active living being one. 20:23.500 --> 20:25.649 Now active living is the environment, infrastructure, 20:25.649 --> 20:27.720 but it's also physical activity 20:27.720 --> 20:31.120 and how those three work together in cohesion 20:31.120 --> 20:33.930 to provide that opportunity for physical activity 20:33.930 --> 20:35.650 to take place on our garrisons. 20:35.650 --> 20:37.635 The second is in culture and behavior change. 20:37.635 --> 20:39.930 That's about education and awareness. 20:39.930 --> 20:41.880 It's great that we make options available, 20:41.880 --> 20:43.610 but if people aren't aware and they don't understand 20:43.610 --> 20:45.388 the reasons why they need to participate in it, 20:45.388 --> 20:47.170 it's really for naught, 20:47.170 --> 20:49.020 so there really is a focus on that 20:49.020 --> 20:49.990 and making sure that we've got 20:49.990 --> 20:52.232 opportunities that are challenging 20:52.232 --> 20:54.860 but also incentivizing our customer base, 20:54.860 --> 20:57.190 our community members to be a part of. 20:57.190 --> 20:58.730 The third is the area of healthy eating, 20:58.730 --> 21:00.063 of course the food environment. 21:00.063 --> 21:01.900 That's the easy one for us all to go to 21:01.900 --> 21:03.260 because it's something we do, 21:03.260 --> 21:04.530 at least for some of us, 21:04.530 --> 21:05.780 three times a day, sometimes more, 21:05.780 --> 21:08.530 but making sure that we have the environment 21:08.530 --> 21:10.414 that support that and that healthier choices are available. 21:10.414 --> 21:14.048 We're looking at nutrient rich, healthier choices. 21:14.048 --> 21:17.940 You'll hear me talk a lot about healthier versus healthy. 21:17.940 --> 21:19.380 And that's because we all have our 21:19.380 --> 21:20.686 own definition of what's healthy. 21:20.686 --> 21:23.150 What's healthy for you might not be healthy for me, 21:23.150 --> 21:24.298 at least in my opinion, right. 21:24.298 --> 21:26.758 So, this is really about challenging each other 21:26.758 --> 21:29.900 about taking your next step in your health journey. 21:29.900 --> 21:31.735 What's the healthier choice for you? 21:31.735 --> 21:33.680 And then making sure that we have those options 21:33.680 --> 21:35.270 available for you to take those choices 21:35.270 --> 21:36.890 and to make that move. 21:36.890 --> 21:39.279 And so, that really is a guiding force for everyone 21:39.279 --> 21:42.763 as we kind of move forward in this overall commitment. 21:43.918 --> 21:46.901 Starting with the active living environment, 21:46.901 --> 21:49.642 looking at infrastructure and environment, 21:49.642 --> 21:52.790 we've all been on garrisons that have been developed 21:52.790 --> 21:55.580 over the last 40, 50 years to be driving communities, 21:55.580 --> 21:58.200 and now it's really about how do we shift that focus 21:58.200 --> 22:00.060 and really drive our communities to be more 22:00.060 --> 22:03.327 walkable and more bikable and friendly in that aspect 22:03.327 --> 22:05.350 for that active living component. 22:05.350 --> 22:07.300 And so in part of that we're working with 22:07.300 --> 22:08.721 Army Public Health Center through tools 22:08.721 --> 22:10.090 that are available to us 22:10.090 --> 22:12.065 such as the military promoting activities tool 22:12.065 --> 22:14.080 which measures the infrastructure environments 22:14.080 --> 22:17.330 ability to support active living choices. 22:17.330 --> 22:19.960 So, if you have hiking and biking trails, 22:19.960 --> 22:21.340 do they take you somewhere? 22:21.340 --> 22:22.467 Do they connect you to something? 22:22.467 --> 22:23.980 Are they well maintained? 22:23.980 --> 22:24.813 Are they well lit? 22:24.813 --> 22:25.646 Those types of things. 22:25.646 --> 22:27.830 And then using that tool and that dataset 22:27.830 --> 22:29.691 then to guide the area development plans 22:29.691 --> 22:32.900 that then shape the decisions that our master planners are 22:32.900 --> 22:35.430 making for our garrisons 30, 40 years down the road. 22:35.430 --> 22:37.480 So, we're super excited about the work 22:37.480 --> 22:39.010 that's being done there because we realize 22:39.010 --> 22:40.850 it's not about just the change today, 22:40.850 --> 22:42.262 it's the change for the future 22:42.262 --> 22:44.930 and really laying that foundation for our youth 22:44.930 --> 22:46.546 as they grow up and make the decision 22:46.546 --> 22:48.336 to serve in their country. 22:48.336 --> 22:50.810 Along that same lines it's also about 22:50.810 --> 22:53.900 you know I talked about master planners working with DA G-9 22:53.900 --> 22:55.640 to ensure that regulation is in place 22:55.640 --> 22:57.690 that guides those master planners just to make sure 22:57.690 --> 22:59.960 that they have opportunities for community gardens 22:59.960 --> 23:01.840 that when you're building a new barrack space 23:01.840 --> 23:05.050 that it's in close proximity to recreation facilities 23:05.050 --> 23:05.940 and the things that they need 23:05.940 --> 23:07.574 to stay active and to stay connected. 23:07.574 --> 23:10.447 Right down to even building designs like 23:10.447 --> 23:11.880 when you walk in the front door, 23:11.880 --> 23:13.267 don't put the elevator bank right there, 23:13.267 --> 23:14.660 but the stairs there, 23:14.660 --> 23:16.440 make them walk around the corner and down the hall 23:16.440 --> 23:17.370 to get to the elevators. 23:17.370 --> 23:19.100 You know, it's just simple little things that we 23:19.100 --> 23:21.591 sometimes take for granted that by working together 23:21.591 --> 23:23.840 and putting in regulations and policies 23:23.840 --> 23:25.360 that drive those kinds of things, 23:25.360 --> 23:27.357 really will shape our future as well look at the 23:27.357 --> 23:29.940 possibilities when it comes to active living. 23:29.940 --> 23:31.153 And just to brag a little bit, 23:31.153 --> 23:34.410 even simple things like repurposing spaces 23:34.410 --> 23:35.810 that we already have on our garrisons. 23:35.810 --> 23:37.555 So, for instance, at Fort Benning, Georgia, 23:37.555 --> 23:41.240 we're piloting a scenario where 18 holes 23:41.240 --> 23:42.169 of the existing golf course, 23:42.169 --> 23:43.738 which was underutilized, 23:43.738 --> 23:46.270 we've now taken nine of those to be foot golf, 23:46.270 --> 23:47.650 and nine to be disc golf, 23:47.650 --> 23:49.950 again just fun exciting ways to get families 23:49.950 --> 23:51.290 out there doing something different 23:51.290 --> 23:52.940 than maybe they hadn't done before, 23:52.940 --> 23:55.130 but we're just not letting that space go to waste, you know. 23:55.130 --> 23:57.970 Opening the trails for the stroller clubs 23:57.970 --> 23:59.180 to use and those kinds of things. 23:59.180 --> 24:02.100 Again, so it's about repurposing as well as identifying 24:02.100 --> 24:04.420 what we can do in the future to really make 24:04.420 --> 24:06.773 these things exciting and possible. 24:08.030 --> 24:09.829 The healthy eating environment of course, 24:09.829 --> 24:12.650 that's probably been the most exciting aspect 24:12.650 --> 24:13.670 of what we've been able to do 24:13.670 --> 24:15.975 in the last four years together as a team. 24:15.975 --> 24:17.780 I'm sure you've noticed, 24:17.780 --> 24:18.820 maybe you didn't realize it, 24:18.820 --> 24:20.530 but in the Exchange alone, 24:20.530 --> 24:21.970 when you walk into the Express now, 24:21.970 --> 24:24.700 you'll see BE FIT end caps with healthier choices available. 24:24.700 --> 24:26.380 You see healthier choices labels on the 24:26.380 --> 24:27.990 aisles of the Express store. 24:27.990 --> 24:29.590 Four years ago that didn't exist 24:29.590 --> 24:31.220 and that was all because of this partnership 24:31.220 --> 24:32.430 of the Healthy Army Communities 24:32.430 --> 24:34.820 that The Exchange is committed to doing those things 24:34.820 --> 24:36.167 and to making those changes to make sure 24:36.167 --> 24:38.260 the healthier choices are available. 24:38.260 --> 24:40.280 Right down to looking at national brands 24:40.280 --> 24:41.394 that we have on our garrison, 24:41.394 --> 24:45.010 as contracts have expired or underperforming brands 24:45.010 --> 24:45.843 have come to the front, 24:45.843 --> 24:49.040 taking that opportunity to bring in national brands 24:49.040 --> 24:52.270 that maybe have a healthier menu availability for them. 24:52.270 --> 24:54.100 And so, it's a strong commitment of theirs 24:54.100 --> 24:55.920 and we're very proud that they're doing that 24:55.920 --> 24:56.910 and it's aligned with what we're doing 24:56.910 --> 24:58.327 at Healthy Army Communities. 24:58.327 --> 24:59.700 For our commissaries, 24:59.700 --> 25:02.182 two years ago they rolled out the nutrition guide program. 25:02.182 --> 25:03.490 I don't know if you know this 25:03.490 --> 25:05.423 but our grocery stores, the Commissaries, 25:05.423 --> 25:07.560 are the only one in the country 25:07.560 --> 25:08.960 that have done the work for you 25:08.960 --> 25:11.720 and provide labeling on the shelves in the Commissary 25:11.720 --> 25:13.330 that identify the healthier choices 25:13.330 --> 25:15.443 with the green thumbs up that you'll see if you go in there. 25:15.443 --> 25:17.850 And so you don't have to pick up every single box 25:17.850 --> 25:18.683 to look at the choices, 25:18.683 --> 25:19.750 they've done that work for you, 25:19.750 --> 25:20.583 they present it for you 25:20.583 --> 25:22.290 and that's just exciting, great work. 25:22.290 --> 25:24.680 Again, it's about making healthy choice easy 25:24.680 --> 25:26.740 and so we're excited about what they're doing with that. 25:26.740 --> 25:28.691 With also their dietician approved grab-n-goes 25:28.691 --> 25:31.154 and some of their meal solutions that you have online 25:31.154 --> 25:33.460 as a resource as well. 25:33.460 --> 25:34.660 When it comes to Army G-4 25:34.660 --> 25:37.330 and what we're doing in our dining facilities, 25:37.330 --> 25:38.890 the Joint Culinary Center of Excellence 25:38.890 --> 25:40.590 has done a lot of work in the last couple of years. 25:40.590 --> 25:41.760 You know we had Go For Green 25:41.760 --> 25:43.530 and then we went Go For Green 2.0, 25:43.530 --> 25:45.080 now we're on Go For Green Army, 25:45.080 --> 25:47.350 again, it's about putting in new recipes, 25:47.350 --> 25:48.880 making sure options are available 25:48.880 --> 25:51.540 for our vegetarians and vegans and gluten free, 25:51.540 --> 25:53.670 and making sure that our young, single soldiers 25:53.670 --> 25:55.140 that are eating in those dinning facilities 25:55.140 --> 25:56.710 have those healthier choices available. 25:56.710 --> 25:59.130 Again, they make that choice if it's not there. 25:59.130 --> 26:01.150 And so, we're really excited about the work 26:01.150 --> 26:02.900 they're doing there along with also putting in some 26:02.900 --> 26:07.050 mobile feeding options as well as a kiosk as well. 26:07.050 --> 26:08.080 For family in MWR, 26:08.080 --> 26:10.680 we have a 25% requirement now on our food and beverage 26:10.680 --> 26:12.470 operations that all menus have to have 26:12.470 --> 26:14.940 25% of it to be a healthy menu item 26:14.940 --> 26:16.268 that meets a nutritional requirement. 26:16.268 --> 26:18.460 It was unheard of a few years ago 26:18.460 --> 26:19.440 and now that's in place. 26:19.440 --> 26:21.830 And again, it's about putting in that infrastructure 26:21.830 --> 26:23.630 to support the overall environment 26:23.630 --> 26:25.790 to right down to a healthy food truck pilot, 26:25.790 --> 26:27.750 our own grab and go for healthy stuff. 26:27.750 --> 26:29.510 So, again, it's exciting stuff. 26:29.510 --> 26:31.500 And then, together, all of the stakeholders 26:31.500 --> 26:33.871 we're working on a new program for campus style dining 26:33.871 --> 26:35.780 which is going to allow our meal card holders 26:35.780 --> 26:37.310 to eat outside the dining facility 26:37.310 --> 26:40.040 using their meal entitlement because we as stakeholders 26:40.040 --> 26:42.010 have finally put together a foundation 26:42.010 --> 26:43.330 where healthy choices can be made. 26:43.330 --> 26:44.809 So, now it makes sense for them 26:44.809 --> 26:47.230 to follow that university campus dining model 26:47.230 --> 26:48.701 and be able to use that meal entitlement 26:48.701 --> 26:50.900 at other places outside the dining facility 26:50.900 --> 26:53.810 because now we have committed healthier choices available. 26:53.810 --> 26:55.630 So, again, a lot of great work being done 26:55.630 --> 26:57.243 in the healthy eating environment 26:57.243 --> 26:59.310 and we're just really excited about all 26:59.310 --> 27:00.560 that they have going on there. 27:00.560 --> 27:03.400 On the culture behavior change, 27:03.400 --> 27:05.210 you know again it's about education awareness 27:05.210 --> 27:06.860 and there's a lot of different partners 27:06.860 --> 27:08.030 that are involved in that. 27:08.030 --> 27:10.210 But one of the things I did want to share with everyone, 27:10.210 --> 27:12.760 you know MEDCOM for a couple of years now 27:12.760 --> 27:16.049 have had the tobacco free campuses model 27:16.049 --> 27:17.660 and so we're using that model 27:17.660 --> 27:19.990 and we're saying how can we take that one step further, 27:19.990 --> 27:22.600 what's the next healthy step when it comes 27:22.600 --> 27:24.700 for tobacco sensation on our garrisons. 27:24.700 --> 27:27.162 So, we're looking at our garrisons 27:27.162 --> 27:29.583 to identify zones where maybe we have 27:29.583 --> 27:32.810 child and youth activities, recreation activities, 27:32.810 --> 27:34.170 is the three or four block radius 27:34.170 --> 27:36.270 where those facilities are all around each other 27:36.270 --> 27:38.260 and then created a tobacco free zone. 27:38.260 --> 27:40.900 Again, with the intent of shading our youth 27:40.900 --> 27:43.360 from the behavior of tobacco use. 27:43.360 --> 27:45.440 So, it'll probably be years, 27:45.440 --> 27:46.890 it took us 50 years to wear a seatbelt 27:46.890 --> 27:48.280 so it'll probably take us a few years to get to 27:48.280 --> 27:49.820 where we're completely tobacco free, 27:49.820 --> 27:52.080 but if we can take that one next step 27:52.080 --> 27:53.531 and create some tobacco free zones, 27:53.531 --> 27:55.470 I think it's a great win for everybody 27:55.470 --> 27:57.393 and it just keeps the conversation moving forward 27:57.393 --> 28:00.020 in a great positive way. 28:00.020 --> 28:02.040 And so, really, what it comes down to is 28:02.040 --> 28:04.118 how do you get involved? 28:04.118 --> 28:07.580 You know, a lot of what we've done is because 28:07.580 --> 28:08.660 we heard your voices. 28:08.660 --> 28:10.370 Families said we'll make a healthy choice 28:10.370 --> 28:11.700 if you make it available. 28:11.700 --> 28:13.780 And so the stakeholders have ponied up, 28:13.780 --> 28:14.820 they've done the hard work, 28:14.820 --> 28:16.450 they've started laying the foundation to make 28:16.450 --> 28:17.773 those healthier choices available, 28:17.773 --> 28:19.300 so now what I need you to do is 28:19.300 --> 28:21.450 make your next step, 28:21.450 --> 28:22.649 take that next healthy choice, 28:22.649 --> 28:26.170 go support your MWR facilities that are providing it, 28:26.170 --> 28:27.858 go the Exchange, go to your commissary, 28:27.858 --> 28:29.780 support those young soldiers 28:29.780 --> 28:31.090 that eat in the dining facilities 28:31.090 --> 28:32.814 and encourage them to make the healthy choice 28:32.814 --> 28:35.990 because together we have an opportunity 28:35.990 --> 28:37.650 to really shape the future of where 28:37.650 --> 28:39.480 we're going for our communities. 28:39.480 --> 28:40.760 Each and every one of you is a part 28:40.760 --> 28:41.975 of a Healthy Army Community, 28:41.975 --> 28:44.780 I'm proud to be a member of the Healthy Army Community 28:44.780 --> 28:46.610 and so take your next step, 28:46.610 --> 28:47.456 make the healthy choice 28:47.456 --> 28:49.825 because if you take it you might like it. 28:49.825 --> 28:50.694 Thank you. 28:50.694 --> 28:52.944 (clapping) 28:58.361 --> 28:59.294 Oh, sorry. 28:59.294 --> 29:00.294 - Thank you. 29:03.760 --> 29:05.750 I'm very happy to be here today. 29:05.750 --> 29:08.052 You might have wondered when I was introduced 29:08.052 --> 29:10.528 why I'm here since I'm not part 29:10.528 --> 29:13.810 of the Army Public Health Center. 29:13.810 --> 29:16.500 I direct the Military Family Research Institute 29:16.500 --> 29:18.166 at Purdue University, 29:18.166 --> 29:21.290 but I'm not here representing them either. 29:21.290 --> 29:24.450 I'm here today because I recently served on a 29:24.450 --> 29:26.874 National Academies of Science panel 29:26.874 --> 29:30.210 which was asked with the 29:30.210 --> 29:32.810 Office of Military Community and Family Policy 29:32.810 --> 29:35.380 as its client to think about the 29:35.380 --> 29:38.360 Military Family Readiness System for the future. 29:38.360 --> 29:40.690 So, our client was from OSD, 29:40.690 --> 29:43.070 therefore we weren't talking specifically about 29:43.070 --> 29:46.400 any specific branch of service, 29:46.400 --> 29:50.250 this was intended to be a big picture look 29:50.250 --> 29:53.030 and in the brief time that I have with you today, 29:53.030 --> 29:55.690 I'm gonna just share one conclusion, 29:55.690 --> 30:00.438 offer you one piece of food for thought as an appetizer 30:00.438 --> 30:05.340 for a much longer report and recommendations. 30:05.340 --> 30:06.980 It's downloadable for free, 30:06.980 --> 30:11.790 my last slide has where you can go to do that. 30:11.790 --> 30:14.670 Let me just explain that like many 30:14.670 --> 30:19.670 of other reports that you have seen, 30:20.610 --> 30:23.160 it included some of the usual kinds 30:23.160 --> 30:25.370 of activities you might expect. 30:25.370 --> 30:29.260 Careful examination of the existing scientific literature, 30:29.260 --> 30:32.310 public hearings, perhaps some of you were there. 30:32.310 --> 30:36.200 We also commissioned papers by other scholars 30:36.200 --> 30:39.893 and we invited comments from a large list 30:39.893 --> 30:43.932 of military serving, non-profits, 30:43.932 --> 30:48.620 organizations of military members and spouses and others. 30:48.620 --> 30:51.220 We also have lots of arguments on the committee 30:51.220 --> 30:53.390 as you might imagine, 30:53.390 --> 30:57.293 you get 14 or so academics and practitioners in a room, 30:57.293 --> 30:59.481 there were raised voices sometimes, 30:59.481 --> 31:02.180 thankfully the National Academies books dinners 31:02.180 --> 31:04.900 at nice places so you can get back together 31:04.900 --> 31:08.000 and start to like each other again over dinner. 31:08.000 --> 31:11.170 But vigorous discussions and a lot of work 31:11.170 --> 31:14.750 and hopefully the report is useful to you. 31:14.750 --> 31:18.140 I think one fundamental recognition 31:18.140 --> 31:20.490 which we just assumed to be true in a way, 31:20.490 --> 31:23.600 although we also know that the literature supports this 31:23.600 --> 31:25.040 and of course you all know it too, 31:25.040 --> 31:26.680 but I want to acknowledge it 31:26.680 --> 31:29.190 because we think it is so important. 31:29.190 --> 31:33.280 Families are not just a supporting cast for service members. 31:33.280 --> 31:37.450 Families are partners in the production of military service. 31:37.450 --> 31:40.620 And so, all of our work was really 31:40.620 --> 31:43.730 predicated with that idea. 31:43.730 --> 31:46.730 Families stand side by side with their service members, 31:46.730 --> 31:50.930 not behind them and not off in some other place. 31:50.930 --> 31:52.260 And I know you all know that 31:52.260 --> 31:55.883 but I felt that it was important to say today. 32:02.550 --> 32:04.410 This is such an obvious statement, 32:04.410 --> 32:06.990 families are always changing. 32:06.990 --> 32:09.460 And yet, when we look around our society, 32:09.460 --> 32:12.180 it's the case that many of our organizations 32:12.180 --> 32:14.230 and our policies and our practices, 32:14.230 --> 32:17.170 and our programs operate in ways 32:17.170 --> 32:20.210 that don't necessarily acknowledge this 32:20.210 --> 32:23.540 very simple statement as much as they would like. 32:23.540 --> 32:26.930 And so, I wanted to give you just a tiny bit 32:26.930 --> 32:30.710 of information about how families have been changing. 32:30.710 --> 32:35.013 Today, cohabitation is as common as marriage. 32:35.860 --> 32:40.250 Today, marriage and parenthood are decoupling. 32:40.250 --> 32:44.140 Over 40% of children in American society 32:44.140 --> 32:47.460 are now born outside of marriage. 32:47.460 --> 32:50.130 Young adults entering the military today 32:50.130 --> 32:52.968 have experienced more family transitions 32:52.968 --> 32:56.349 in their own past and in the lives of their families 32:56.349 --> 32:59.220 than was the case in service members 32:59.220 --> 33:01.920 joining in a prior generation. 33:01.920 --> 33:05.800 Family diversity is growing. 33:05.800 --> 33:09.230 Family instability is also growing. 33:09.230 --> 33:12.600 Family diversity is not necessarily a problem. 33:12.600 --> 33:15.830 Family instability is potentially a problem 33:15.830 --> 33:20.060 and appears to have significant negative implications 33:20.060 --> 33:22.890 for children under some circumstances. 33:22.890 --> 33:27.410 Even more concerning is that the behavior in our society 33:27.410 --> 33:31.330 by different groups of people is diverging by education. 33:31.330 --> 33:33.340 And so, highly educated people 33:33.340 --> 33:35.599 are more likely to marry each other, 33:35.599 --> 33:37.550 they're more likely to get married, 33:37.550 --> 33:38.820 more likely to stay married, 33:38.820 --> 33:41.610 they're more likely to have their children inside marriage. 33:41.610 --> 33:43.330 Less educated people, 33:43.330 --> 33:44.600 less likely to marry, 33:44.600 --> 33:46.100 more likely to divorce, 33:46.100 --> 33:48.253 more likely to have their children outside of marriage, 33:48.253 --> 33:52.180 more likely to have children from multiple partners. 33:52.180 --> 33:56.050 Both of these realities exists and one of the reasons 33:56.050 --> 33:58.060 that people are concerned in particular 33:58.060 --> 34:00.930 or think that this type of behavior 34:00.930 --> 34:03.060 among less educated people is growing 34:03.060 --> 34:05.463 is because of financial instability. 34:06.570 --> 34:10.570 Let me illustrate just a little bit this point. 34:12.320 --> 34:13.890 Sorry. 34:13.890 --> 34:15.032 Here. 34:15.032 --> 34:16.650 Between 1970, 34:16.650 --> 34:19.050 so right before the beginning of the all volunteer force, 34:19.050 --> 34:20.090 and 2014, 34:20.090 --> 34:23.154 here's what we saw in changes in U.S. society 34:23.154 --> 34:25.870 in the growth or shrinkage of 34:25.870 --> 34:27.540 different kinds of family forms. 34:27.540 --> 34:31.330 So, married couples with children fell 26%. 34:31.330 --> 34:34.590 Every other family form grew. 34:34.590 --> 34:37.880 Householders with partners and/or children 34:37.880 --> 34:40.820 in their households grew 220%. 34:40.820 --> 34:43.430 Now, among military families, 34:43.430 --> 34:46.010 all of those blue arrows still represent 34:46.010 --> 34:49.730 a relatively small portion of the overall 34:49.730 --> 34:51.739 to the extent that we know. 34:51.739 --> 34:54.220 Married couple families are still 34:54.220 --> 34:56.800 a very large percentage of the group, 34:56.800 --> 34:58.600 but they're shrinking, 34:58.600 --> 35:01.740 they're shrinking as a percentage. 35:01.740 --> 35:06.740 And so the dilemma is which families do you serve? 35:08.360 --> 35:10.330 Do you sort of hold fast and say 35:10.330 --> 35:12.580 no we think the best kind of family is the 35:12.580 --> 35:15.080 family that fits through this box, 35:15.080 --> 35:18.539 or do we acknowledge the families that we really have? 35:18.539 --> 35:22.730 Over the last 30 years and potentially in the next 30 years 35:22.730 --> 35:25.400 what you will see is military programs, 35:25.400 --> 35:28.900 practices and policies gradually diverging 35:28.900 --> 35:31.960 from the families that the military actually has 35:31.960 --> 35:34.870 and covering potentially a smaller and smaller 35:34.870 --> 35:39.070 percentage of the families that you actually have. 35:39.070 --> 35:41.660 Today, there are families who are invisible. 35:41.660 --> 35:44.754 You have families that we don't really know much about. 35:44.754 --> 35:48.870 A spouse survey that we just heard about was for spouses. 35:48.870 --> 35:51.500 Well, what about those 220% increase 35:51.500 --> 35:53.860 in unmarried partners with children? 35:53.860 --> 35:55.270 You have those folks too, 35:55.270 --> 35:59.530 but they're not in these sorts of surveys. 35:59.530 --> 36:01.915 For sometimes very good reasons, 36:01.915 --> 36:04.890 but not having any information at all 36:04.890 --> 36:07.819 might prevent good decision making. 36:07.819 --> 36:10.176 And so, one of our recommendations was 36:10.176 --> 36:13.950 that we really need to try to understand better 36:13.950 --> 36:16.770 the diversity of the families that you really have 36:16.770 --> 36:18.979 that are really in the military. 36:18.979 --> 36:23.486 The committee recognizes fully that you can't treat 36:23.486 --> 36:26.750 everyone like you now treat spouses, 36:26.750 --> 36:30.310 you can't incorporate everybody under that big tent, 36:30.310 --> 36:34.040 it would be impractical and too expensive, 36:34.040 --> 36:36.730 but we think that there are reasons to be 36:36.730 --> 36:38.590 able to ask these three questions, 36:38.590 --> 36:41.010 who provides care and support for service members 36:41.010 --> 36:42.520 both married and unmarried? 36:42.520 --> 36:44.130 Who should be the targets of the 36:44.130 --> 36:45.690 Military Family Readiness System? 36:45.690 --> 36:47.110 And most important, 36:47.110 --> 36:49.754 which parts of the system can address 36:49.754 --> 36:54.660 which part of service members support systems? 36:54.660 --> 36:57.410 This last slide if I can get it to come up, 36:57.410 --> 36:59.850 but if not I'm sure it'll be posted. 36:59.850 --> 37:00.683 All right you can see it, 37:00.683 --> 37:02.420 the National Academies, 37:02.420 --> 37:03.810 you can download the report there. 37:03.810 --> 37:05.530 My email address is really easy, 37:05.530 --> 37:08.152 you can just email me and I will send you the link. 37:08.152 --> 37:10.589 Thank you for your attention. 37:10.589 --> 37:12.839 (clapping) 37:17.658 --> 37:19.650 - I only have one slide so it should be 37:19.650 --> 37:22.603 really easy to navigate this clicker. 37:23.520 --> 37:25.690 At the end of my signature block at work 37:25.690 --> 37:26.557 I have a quote that says, 37:26.557 --> 37:28.167 "Success means we go to sleep at night 37:28.167 --> 37:29.667 "knowing that our talents and abilities 37:29.667 --> 37:31.920 "were used in a way that served others." 37:31.920 --> 37:33.843 Our spouses, I'm a military spouse, 37:33.843 --> 37:37.460 so our spouses serve and I think that we serve as well. 37:37.460 --> 37:40.150 And while the way that we serve is different, 37:40.150 --> 37:43.413 it absolutely requires us to be resilient. 37:47.430 --> 37:48.263 Even knowing that, 37:48.263 --> 37:49.327 that it requires resiliency, 37:49.327 --> 37:53.010 and hosting resiliency events for military children 37:53.010 --> 37:55.510 with the Military Child Education Coalition, 37:55.510 --> 37:58.570 I'm the Master Resilient Trainer, etc., 37:58.570 --> 38:02.448 when they asked me to be on this panel three days ago 38:02.448 --> 38:05.150 I wasn't quite sure what I was going to say 38:05.150 --> 38:07.460 'cause I thought that this was a little bit different 38:07.460 --> 38:08.700 than when you're up there teaching 38:08.700 --> 38:10.253 or you're hosting an event. 38:11.160 --> 38:13.495 Honestly, I'm super nervous. 38:13.495 --> 38:15.713 So, I wrote talking points. 38:16.580 --> 38:19.350 I got feedback from someone that I trusted 38:19.350 --> 38:22.450 and then I edited those talking points, 38:22.450 --> 38:24.350 and then there I was yesterday 38:24.350 --> 38:26.400 picking out my favorite baking book 38:26.400 --> 38:29.690 because on Friday all my kids tested positive for the flu. 38:29.690 --> 38:31.540 I'm not contagious just FYI. 38:31.540 --> 38:32.610 Right, yeah, right. 38:32.610 --> 38:35.610 So, didn't even know it. 38:35.610 --> 38:37.570 Anyway, and out fell this note 38:37.570 --> 38:39.350 and it was written on packing paper 38:39.350 --> 38:40.840 and y'all know what that is right, 38:40.840 --> 38:43.033 brown packing paper fold it up everywhere, 38:43.880 --> 38:45.759 it said something, it said, 38:45.759 --> 38:50.250 "You are the best battle buddy a girl could ask for." 38:50.250 --> 38:52.121 I might cry. (sobbing) 38:52.121 --> 38:53.207 I'm sorry. 38:53.207 --> 38:55.307 "You are the best battle buddy a girl could ask for. 38:55.307 --> 38:57.487 "You are so strong and such an inspiration 38:57.487 --> 38:59.127 "and I am excited to visit. 38:59.127 --> 39:01.670 "yes, I invited myself and beer" 39:01.670 --> 39:02.503 I do drink beer. 39:02.503 --> 39:03.864 "Love, Kelly." 39:03.864 --> 39:07.430 I have three more of those written on packing paper 39:07.430 --> 39:11.122 and they were stuffed inside packing boxes three years ago 39:11.122 --> 39:14.380 when we made our move to APG. 39:14.380 --> 39:15.392 When I say we it was, 39:15.392 --> 39:17.380 we have four children, 39:17.380 --> 39:19.540 it was my three younger children and I. 39:19.540 --> 39:21.310 My husband was deployed to Afghanistan 39:21.310 --> 39:24.839 and the Army decided to throw us another curve ball, 39:24.839 --> 39:26.963 I'll explain it all later, 39:28.440 --> 39:31.350 and so with that curve ball 39:33.088 --> 39:35.210 my husband and I were facetiming in Afghanistan 39:35.210 --> 39:39.203 decided that I should take a job in Aberdeen Proving Ground 39:39.203 --> 39:40.730 if I could get one. 39:40.730 --> 39:41.563 And I did, 39:41.563 --> 39:43.640 a lot quicker than I thought I was going to. 39:43.640 --> 39:46.640 So, I packed up all three children by myself 39:46.640 --> 39:50.170 because this wasn't a military ordered move to come here, 39:50.170 --> 39:52.173 and we moved to APG. 39:54.350 --> 39:56.443 I just want to say that, 39:58.370 --> 39:59.443 I want to pause for one second too 39:59.443 --> 40:01.230 because this was not in my notes, 40:01.230 --> 40:03.000 but I was listening to panel one 40:03.000 --> 40:05.110 and everybody else that was talking earlier today 40:05.110 --> 40:07.300 and as I'm writing this I'm like I don't know 40:07.300 --> 40:09.180 what I'm gonna write about, etc., etc., 40:09.180 --> 40:10.015 and as you can see, 40:10.015 --> 40:12.110 this I put together Thursday, 40:12.110 --> 40:12.943 so I apologize, 40:12.943 --> 40:14.090 but they were like what is resiliency. 40:14.090 --> 40:15.731 I'm like mm-hmm, right, 40:15.731 --> 40:19.043 community, purpose, contentment, impact. 40:19.043 --> 40:22.290 For me it's really about community 40:22.290 --> 40:24.960 and I just think that everybody on panel one 40:24.960 --> 40:27.610 and all the other research that is done 40:27.610 --> 40:31.040 is really just reiterates that for me, 40:31.040 --> 40:32.270 how important community is. 40:32.270 --> 40:34.530 So, I feel humbled and honored to be able 40:34.530 --> 40:37.590 to talk just a teeny bit about what community means to me 40:37.590 --> 40:39.323 as a military spouse. 40:42.268 --> 40:45.610 As military spouses I think resiliency means 40:45.610 --> 40:49.210 that we take every adversity, every move, every deployment, 40:49.210 --> 40:51.110 my husband's been on three combat deployments 40:51.110 --> 40:54.482 and he's been on three hardship tours and multiple TDYs 40:54.482 --> 40:55.380 and I don't have to tell any of you 40:55.380 --> 40:58.240 spouses out there anything about that, 40:58.240 --> 41:00.147 but we take every deployment and every new school 41:00.147 --> 41:02.040 and every best friendship 41:02.040 --> 41:04.016 turned into a long distance relationship 41:04.016 --> 41:06.347 and we do what we have to do 41:06.347 --> 41:08.990 because our soldiers need us too, 41:08.990 --> 41:10.120 and our kids need us too, 41:10.120 --> 41:11.990 and we just do it. 41:11.990 --> 41:13.170 I don't think that's ever gonna change 41:13.170 --> 41:14.300 and I think that's fantastic, 41:14.300 --> 41:18.210 and it speaks a lot about the strength of military spouses. 41:18.210 --> 41:20.010 But I also believe that resiliency is more 41:20.010 --> 41:21.670 than just bouncing back from adversity 41:21.670 --> 41:23.700 and doing what we have to do. 41:23.700 --> 41:26.350 I believe it's about community, impact, 41:26.350 --> 41:28.780 contentment, and purpose. 41:28.780 --> 41:30.620 So today I'm gonna talk just a little bit about 41:30.620 --> 41:32.073 that type of resiliency. 41:33.084 --> 41:34.790 Because before all of this, 41:34.790 --> 41:37.433 before becoming a military spouse, mother of four, 41:37.433 --> 41:38.973 having a career, 41:41.490 --> 41:43.250 I couldn't stand people like you. 41:43.250 --> 41:44.160 Right, and people like you, 41:44.160 --> 41:47.200 no, I'm being serious, why are you laughing. 41:47.200 --> 41:48.863 People who were dressed nice, 41:48.863 --> 41:50.600 people in uniform, 41:50.600 --> 41:53.840 ironic I know because I'm married to a man in uniform, 41:53.840 --> 41:56.200 right, but if you look like you are successful, 41:56.200 --> 41:57.960 if you weren't wearing dirty clothes, 41:57.960 --> 42:00.130 if you had a place to live, 42:00.130 --> 42:01.253 I despised you. 42:02.170 --> 42:03.950 And I despised you because I didn't think 42:03.950 --> 42:05.850 that you were there when I needed you. 42:09.660 --> 42:11.520 And then one day, 42:11.520 --> 42:14.553 at a coffee in Vilseck, Germany, 42:14.553 --> 42:15.830 when we were stationed with 42:15.830 --> 42:17.660 two of our first Field Support Battalion, 42:17.660 --> 42:21.067 my husband's commander's wife came up to me and said, 42:21.067 --> 42:23.267 "You know something happened to me yesterday, Elizabeth, 42:23.267 --> 42:24.647 "and I really wanted to share it with you 42:24.647 --> 42:26.947 "because I really knew that you would get it." 42:28.080 --> 42:29.490 And then she shared this something with me 42:29.490 --> 42:31.350 and it was really personal and impactful for her 42:31.350 --> 42:33.140 in her personal life, 42:33.140 --> 42:36.080 and I think that was one of the first times 42:36.080 --> 42:39.543 I felt like someone besides my husband saw me. 42:40.650 --> 42:43.432 Not the daughter of a drug addict single mother, 42:43.432 --> 42:45.660 who only had dirty clothes, 42:45.660 --> 42:47.163 was on the run all the time. 42:48.030 --> 42:53.030 I thought, wow, to be a part of a community like this 42:53.769 --> 42:56.490 (sighing) 42:56.490 --> 43:01.380 and that's when I thought that community really matters. 43:01.380 --> 43:03.160 Before then I was like I don't trust anybody, 43:03.160 --> 43:04.850 I don't want anything to do with anybody, right, 43:04.850 --> 43:06.100 I'll do it all on my own. 43:06.940 --> 43:09.763 And then spouses like you changed that for me. 43:10.680 --> 43:11.780 You changed that. 43:13.570 --> 43:15.820 So you see resiliency isn't just about that 43:15.820 --> 43:17.630 bouncing back from adversity, 43:17.630 --> 43:21.780 it's rising above all of that, 43:21.780 --> 43:23.780 those things that you have no control over, 43:23.780 --> 43:25.910 it's learning to love and be content with yourself 43:25.910 --> 43:28.440 and with the life you've been given. 43:28.440 --> 43:30.380 It's finding your purpose and whether that be 43:30.380 --> 43:33.386 in your volunteer work or your career, or both, 43:33.386 --> 43:36.330 and then it's building that through community 43:36.330 --> 43:37.680 like the ones that we have. 43:39.090 --> 43:40.650 As military spouses I feel that 43:40.650 --> 43:42.280 we're blessed to be a part of one of the 43:42.280 --> 43:43.940 greatest communities on the planet. 43:43.940 --> 43:44.773 I do. 43:44.773 --> 43:45.960 I know that's a little biased, 43:45.960 --> 43:47.353 but I believe it. 43:48.764 --> 43:52.130 We know how to encourage and inspire each other. 43:52.130 --> 43:55.503 We share love and loss and fear with each other. 43:56.970 --> 43:58.430 And because of that I don't believe that 43:58.430 --> 44:00.020 I could be where I am today, 44:00.020 --> 44:01.330 that we could make the impact on the 44:01.330 --> 44:03.483 communities that we do everywhere we go. 44:04.383 --> 44:08.450 I'm beyond proud to love a man that defends a country 44:08.450 --> 44:09.820 where a girl like me, right, 44:09.820 --> 44:12.590 abused, abandoned, emancipated at 16, 44:12.590 --> 44:16.470 can be a part of such an incredible, incredible community. 44:16.470 --> 44:18.690 It makes an impact wherever we go. 44:18.690 --> 44:20.350 So, I think leaving today, 44:20.350 --> 44:22.390 and I'm exactly at zero seconds, right, 44:22.390 --> 44:25.468 leaving today I just want to say thank you 44:25.468 --> 44:28.770 to all the other military spouses out there 44:28.770 --> 44:30.927 who make an impact wherever they go. 44:30.927 --> 44:31.869 Thank you. 44:31.869 --> 44:34.119 (clapping) 44:44.690 --> 44:46.869 - [Laura] So, we could've just had Elizabeth up here. 44:46.869 --> 44:48.410 (laughing) 44:48.410 --> 44:50.610 But with that can I take any questions 44:50.610 --> 44:52.513 for our esteemed panel? 44:55.660 --> 44:56.493 Yes? 44:59.559 --> 45:00.392 - [Woman In Audience] I don't think I need it 45:00.392 --> 45:01.560 but I'll take it. 45:01.560 --> 45:04.074 - For our online people they can hear you better that way. 45:04.074 --> 45:07.570 - Elizabeth, thank you, I want to tell you that 45:07.570 --> 45:09.150 I have a 19 year old 45:09.150 --> 45:12.050 and she went to 10 schools. 45:12.050 --> 45:14.350 Our motto, I guess you could say, 45:14.350 --> 45:17.185 would be we're an Army family, 45:17.185 --> 45:20.820 we can handle any adversity. 45:20.820 --> 45:23.530 When I dropped her off at school she was having some issues 45:23.530 --> 45:25.447 and she goes, "Mom, I'll handle it. 45:25.447 --> 45:28.900 "I'm an Army brat, I can handle it." 45:28.900 --> 45:30.460 But thank you. 45:30.460 --> 45:32.710 For our two gentlemen, 45:32.710 --> 45:34.160 I actually have two questions. 45:34.160 --> 45:37.922 One with the new electric health records, 45:37.922 --> 45:42.922 I know the program is actually being redone. 45:43.070 --> 45:45.340 Is the new computer program going to 45:45.340 --> 45:47.900 read the old computer program? 45:47.900 --> 45:51.000 Because I know that's part of the problem 45:51.000 --> 45:53.630 right now that we're seeing. 45:53.630 --> 45:56.594 The other question I have is with the health 45:56.594 --> 46:01.594 with the school age services, 46:01.750 --> 46:04.620 are we doing any classes for kids to 46:04.620 --> 46:06.960 try to get them away from vaping? 46:06.960 --> 46:10.660 We talk about tobacco free zones, 46:10.660 --> 46:12.930 are we gonna do vaping free zones? 46:12.930 --> 46:16.420 The High School my middle child went to had 46:16.420 --> 46:21.420 four arrests and one death two weeks ago from vaping 46:22.176 --> 46:25.343 on a tobacco free area. 46:27.100 --> 46:29.158 - I'll answer your first question first 46:29.158 --> 46:32.280 because I'll talk about your second question 46:32.280 --> 46:33.940 for a long time. 46:33.940 --> 46:35.796 In terms of the new electronic health record, 46:35.796 --> 46:38.120 it's called GENESIS is the term, 46:38.120 --> 46:40.423 it is a commercial off the shelf product, 46:41.260 --> 46:44.020 which one, would make it easier to share 46:44.020 --> 46:46.730 with the private sector, they also use it. 46:46.730 --> 46:48.835 So, some of the problems I talked about here 46:48.835 --> 46:51.163 where not being able to get data 46:51.163 --> 46:54.210 hopefully will go away when that's fully rolled out. 46:54.210 --> 46:56.750 It is also the same electronic health record 46:56.750 --> 46:58.010 that the VA is using. 46:58.010 --> 47:00.350 So, it's gonna make record sharing 47:00.350 --> 47:02.270 across the larger medical enterprise 47:02.270 --> 47:03.950 within the United States easier, 47:03.950 --> 47:08.950 and it will incorporate legacy data from the current AHLTA. 47:09.060 --> 47:12.500 Second question is basically electronic cigarettes, 47:12.500 --> 47:17.010 vaping is covered by the Army's tobacco policies. 47:17.010 --> 47:19.522 We don't make a distinction between a cigarette 47:19.522 --> 47:21.590 and electronic cigarette. 47:21.590 --> 47:24.410 And so, any place that's tobacco free within the Army 47:24.410 --> 47:28.450 is a no vaping situation right now. 47:28.450 --> 47:30.410 And so, we're in the process of 47:30.410 --> 47:32.440 we have educational materials already 47:32.440 --> 47:35.810 that can be used in terms of whether 47:35.810 --> 47:37.990 it's Child and Youth Services health education, 47:37.990 --> 47:42.990 I know what we do is that we have four soldiers 47:42.996 --> 47:47.170 essentially a don't vape either kind of thing. 47:47.170 --> 47:51.440 Now, we are tilting against cultural windmills right now. 47:51.440 --> 47:53.980 The current epidemic or the outbreak we have 47:53.980 --> 47:57.140 there's over a thousand people within the United States 47:57.140 --> 47:58.390 that have fallen ill, 47:58.390 --> 48:00.590 a couple of dozen that have died. 48:00.590 --> 48:05.590 I'm sorry to hear about that that's touched you. 48:07.040 --> 48:10.270 And it's one of those things that we're trying to chase it. 48:10.270 --> 48:11.450 The one point I will make, 48:11.450 --> 48:13.900 I'd be remiss if I didn't do this, 48:13.900 --> 48:15.830 for people to think that 48:15.830 --> 48:18.220 mass marketed electronic cigarettes 48:18.220 --> 48:21.800 are somehow safer than vape juice 48:21.800 --> 48:25.570 that you buy at a pop-up, you're deluding yourself. 48:25.570 --> 48:28.340 All vape juice is dangerous. 48:28.340 --> 48:31.100 It doesn't matter if it's sold by a company that has 48:31.100 --> 48:34.057 enough money to advertise on the NFL, 48:34.057 --> 48:36.950 it just doesn't matter. 48:36.950 --> 48:40.313 Vaping right now is an inherently dangerous act. 48:41.290 --> 48:43.455 In fact, I'm worried, I think vaping currently today 48:43.455 --> 48:46.220 in the United States may be more dangerous 48:46.220 --> 48:47.680 than smoking cigarettes because people 48:47.680 --> 48:49.780 don't die usually after one cigarette. 48:49.780 --> 48:54.760 They can die right now with the first time they vape. 48:59.320 --> 49:00.420 - [Laura] Anyone else? 49:02.270 --> 49:04.090 Yeah, sure. 49:04.090 --> 49:06.720 There's a question right up here in the front. 49:06.720 --> 49:07.553 Thank you. 49:08.984 --> 49:10.406 (woman in audience speaking) 49:10.406 --> 49:12.407 - Hold on he's gonna get the microphone to you. 49:13.340 --> 49:14.490 - [Woman Up Front] Talk about healthy choices 49:14.490 --> 49:15.770 and having the food corner 49:15.770 --> 49:19.500 with some bananas or healthy options 49:19.500 --> 49:22.643 and what you consider healthy it's an opinion. 49:23.660 --> 49:26.040 There's really so much confusion out there 49:26.040 --> 49:28.670 right now of what is healthy to eat and what is not, right. 49:28.670 --> 49:30.280 There's the big plant based movement 49:30.280 --> 49:31.560 and then there's that recent article 49:31.560 --> 49:32.960 in the Annals of Medicine 49:32.960 --> 49:37.200 saying processed meat and red meat are fine. 49:37.200 --> 49:39.270 Even though if you look at all the studies they cited, 49:39.270 --> 49:41.193 it kind of says it's not. 49:42.070 --> 49:44.040 So, there's different guidelines 49:44.040 --> 49:46.040 that have been issued by the government 49:46.040 --> 49:50.650 and the American Heart Association, etc. 49:50.650 --> 49:52.210 Is the Army gonna, 49:52.210 --> 49:54.120 and the confusing diets, 49:54.120 --> 49:56.331 the Keto, the Paleo, the quick weight loss, 49:56.331 --> 49:57.980 burning the fat, 49:57.980 --> 50:00.140 and all these things are going on, 50:00.140 --> 50:02.990 there's so much marketing an misinformation and confusion. 50:02.990 --> 50:05.236 It reminds me of the tobacco industry 50:05.236 --> 50:08.583 before the warnings were on cigarettes. 50:08.583 --> 50:12.280 Is bacon carcinogenic or is it not? 50:12.280 --> 50:13.890 There's a lot of research out there, 50:13.890 --> 50:18.890 is the military gonna eventually somehow take a stand 50:19.470 --> 50:23.190 to give some help to our community to figure out 50:23.190 --> 50:24.760 what is healthy and what is not? 50:24.760 --> 50:26.930 We see articles in Time magazine, 50:26.930 --> 50:28.070 butter is back, 50:28.070 --> 50:29.728 bacon and eggs are great, 50:29.728 --> 50:32.560 it's so confusing. 50:32.560 --> 50:36.762 Can the leaders give some direction? 50:36.762 --> 50:40.326 Is hyperlipidemia really a situation? 50:40.326 --> 50:43.054 It was for the last 50 years. 50:43.054 --> 50:47.143 Cardiovascular disease is our number one killer. 50:48.750 --> 50:50.840 Do we need to get a handle on this? 50:50.840 --> 50:52.710 We see people very fit, 50:52.710 --> 50:54.517 they run, they do the Army 10-miler, 50:54.517 --> 50:56.540 and then you see these same people 50:56.540 --> 50:58.463 unfortunately having heart attacks. 50:59.946 --> 51:04.460 So, there begs some help with not using opinions 51:04.460 --> 51:08.160 and Google searches to figure out what's healthy or not. 51:08.160 --> 51:09.780 - So, I'm gonna make a comment, 51:09.780 --> 51:12.270 I'm looking back at Colonel Deydre Teyhen 51:12.270 --> 51:14.070 and then I'm gonna pass it over to our panelists. 51:14.070 --> 51:15.710 Thank you for bringing it up. 51:15.710 --> 51:17.610 Actually Ms. Barron had one time 51:17.610 --> 51:19.830 we did a panel just on those types of questions 51:19.830 --> 51:22.670 because it's so confusing, right, it's huge. 51:22.670 --> 51:25.730 And the diet industry is a multi-billion dollar industry. 51:25.730 --> 51:27.970 They want you to buy their products, right. 51:27.970 --> 51:32.080 They want the soldiers to use different diet plans 51:32.080 --> 51:34.953 and family members and they market to the 51:35.793 --> 51:38.200 soldiers and to the families. 51:38.200 --> 51:43.200 Colonel Teyhen about maybe five years ago, six years ago, 51:43.480 --> 51:46.612 came up with the plan called the Performance Triad. 51:46.612 --> 51:50.890 Really that was to look at sleep, activity and nutrition 51:50.890 --> 51:53.031 from a very holistic perspective. 51:53.031 --> 51:57.220 We have very fit soldiers and very fit family members 51:57.220 --> 51:58.940 that maybe don't eat so healthy, 51:58.940 --> 52:00.270 or don't sleep so well. 52:00.270 --> 52:03.190 We have a very under slept Army 52:03.190 --> 52:05.220 and she actually has someone working for her, 52:05.220 --> 52:07.290 Colonel Capaldi, who I just met from 52:07.290 --> 52:08.600 Walter Reed Army Institute for Research 52:08.600 --> 52:10.010 which she's a commander, 52:10.010 --> 52:14.440 who is doing phenomenal research in the area of sleep. 52:14.440 --> 52:17.318 So, what we're trying to promote instead of saying 52:17.318 --> 52:22.318 don't do Keto and Tim will talk a little bit about that is 52:22.590 --> 52:24.300 this holistic perspective that you need 52:24.300 --> 52:26.130 to think of all three together. 52:26.130 --> 52:28.160 So, if you're physically active, 52:28.160 --> 52:29.600 you need to be thinking about nutrition 52:29.600 --> 52:30.510 and your sleep as well. 52:30.510 --> 52:32.810 So, we've got a lot of information out there. 52:32.810 --> 52:33.980 We have a site. 52:33.980 --> 52:37.440 We are working commanders on having people understand 52:37.440 --> 52:39.970 that idea of sleep, activity and nutrition together 52:39.970 --> 52:42.650 are going to increase your performance as a family, 52:42.650 --> 52:46.340 as an individual, and as a soldier. 52:46.340 --> 52:50.440 Actually, that started under General Horoho's lead, 52:50.440 --> 52:53.660 and so we're continuing that effort General Horoho. 52:53.660 --> 52:56.770 So, I'll turn it over to Mr. Resta or Tim 52:56.770 --> 52:58.570 to answer a little bit more on that. 52:59.420 --> 53:02.710 - I'll just say that DOD has a food and nutrition 53:02.710 --> 53:06.000 subcommittee that meets regularly with all of the services 53:06.000 --> 53:07.610 and all of the stakeholders 53:07.610 --> 53:09.220 that are in the food environment. 53:09.220 --> 53:10.910 So, we realize there's all of those 53:10.910 --> 53:12.770 education awareness aspects out there. 53:12.770 --> 53:15.050 There's sometimes conflicting messages. 53:15.050 --> 53:17.330 The important thing is that we're coming together 53:17.330 --> 53:19.250 and having those internal conversations 53:19.250 --> 53:21.170 about how do we move this forward. 53:21.170 --> 53:22.320 What are the right answers? 53:22.320 --> 53:24.304 What is the message we want to carry forward? 53:24.304 --> 53:26.290 And now with the alignment and we have the 53:26.290 --> 53:28.170 Defense Health Agency kind of bringing us 53:28.170 --> 53:32.850 all together in a way in which we haven't had in the past, 53:32.850 --> 53:34.850 it's allowing that conversation to move forward 53:34.850 --> 53:36.862 and put into a way that we can message to our 53:36.862 --> 53:39.720 communities and to our individuals. 53:39.720 --> 53:41.760 So, we don't have all the answers yet, 53:41.760 --> 53:43.920 and it's by no means a perfect scenario, 53:43.920 --> 53:46.310 but again, it's about taking that next step. 53:46.310 --> 53:49.410 So, just recognizing the issue and the situation 53:49.410 --> 53:50.260 and then coming together 53:50.260 --> 53:51.970 and having the difficult conversations, 53:51.970 --> 53:54.120 holding each other accountable like I said, 53:54.120 --> 53:56.758 and trying to lay a foundation so that 53:56.758 --> 53:59.380 wherever you go on our installations 53:59.380 --> 54:02.410 that we know at least the healthier choices are available. 54:02.410 --> 54:03.740 They may not be the perfect choices 54:03.740 --> 54:05.630 but at least they're available 54:05.630 --> 54:06.970 and that people can have those. 54:06.970 --> 54:08.832 So, it's a great conversation, 54:08.832 --> 54:12.608 it's a great opportunity for us to rise above 54:12.608 --> 54:16.180 and lead really the nation in a way forward 54:16.180 --> 54:18.700 for health and nutrition absolutely. 54:18.700 --> 54:21.270 - And what I would add is that most of the 54:21.270 --> 54:25.416 nutritional epidemiological studies out there are garbage. 54:25.416 --> 54:29.269 I mean that somewhat jokingly is that 54:29.269 --> 54:31.376 they are either very small samples, 54:31.376 --> 54:34.126 very limited time period, 54:34.126 --> 54:38.230 very restrictive diets that people are really 54:38.230 --> 54:40.330 incapable of keeping for longer 54:40.330 --> 54:42.010 and longer and longer times. 54:42.010 --> 54:43.950 So, to make broad observations 54:43.950 --> 54:45.775 based upon the study of the week, 54:45.775 --> 54:48.847 we have lots of time for 54:48.847 --> 54:52.020 what did you read over the weekend we bring it in 54:52.020 --> 54:54.979 and so whether it was coffee this week or butter, 54:54.979 --> 54:58.610 or bacon or a whole vegan diet, 54:58.610 --> 55:03.610 or any one there are problems with the data as it goes on. 55:04.470 --> 55:06.260 I looked at for me personally, I looked at history. 55:06.260 --> 55:09.493 We look at what people have been eating. 55:11.230 --> 55:14.620 You mentioned the Blue Zones is a great book 55:14.620 --> 55:17.020 for those of you who have not read it. 55:17.020 --> 55:21.570 Every culture has figured a way out to eat to thrive. 55:21.570 --> 55:24.816 And that's what I encourage people to do is 55:24.816 --> 55:27.023 look at what your grandparents ate. 55:29.043 --> 55:30.800 Particularly if they lived a very long time, 55:30.800 --> 55:32.293 definitely look at what your grandparents ate. 55:32.293 --> 55:34.100 (laughing) 55:34.100 --> 55:35.400 Now, if they didn't live that long 55:35.400 --> 55:37.270 there may be a different story but, 55:37.270 --> 55:38.740 or look at what their parents ate 55:38.740 --> 55:40.260 or their grandparents ate 55:40.260 --> 55:42.403 before they came into the United States. 55:44.840 --> 55:47.210 - [Man In Audience] So my question is reference GENESIS, 55:47.210 --> 55:49.200 so I'll give you a little bit of a backstory 55:49.200 --> 55:50.750 and then I'll ask the question. 55:52.850 --> 55:56.344 Recently I lost my son going through the med board process. 55:56.344 --> 55:59.743 One of the problems that was identified during the 15-6 55:59.743 --> 56:03.511 that was conducted was he was seeing a VA doctor, 56:03.511 --> 56:06.120 he was seeing his pain care manager, 56:06.120 --> 56:08.470 he was seeing his primary care manager, 56:08.470 --> 56:10.960 but because they were all on different systems 56:10.960 --> 56:14.700 and because he was being treated for physical ailments 56:14.700 --> 56:19.030 and being asked questions about behavioral health issues, 56:19.030 --> 56:21.080 none of it was connected together, 56:21.080 --> 56:24.560 so when this person's treating him, 56:24.560 --> 56:25.730 and this person's treating him, 56:25.730 --> 56:27.250 they're not seeing the true picture. 56:27.250 --> 56:29.103 Is GENESIS gonna fix that? 56:30.813 --> 56:33.793 - General Place, I can answer what I've been told but. 56:35.450 --> 56:37.600 - [General Place] Yeah, fix is a challenging word. 56:37.600 --> 56:40.000 So the challenge with existing systems 56:40.000 --> 56:41.640 is that they are interoperable 56:41.640 --> 56:44.220 but it takes significant effort to do so. 56:44.220 --> 56:46.340 So, could the practitioners all that you mentioned, 56:46.340 --> 56:47.590 could they have seen all the notes, 56:47.590 --> 56:49.300 the answer is yes, they could've, 56:49.300 --> 56:51.890 it just takes significant effort to get into 56:51.890 --> 56:53.460 each of the different systems to do so. 56:53.460 --> 56:56.830 The advantage of MHS GENESIS is the platform is the same, 56:56.830 --> 56:58.700 the note structure is the same, 56:58.700 --> 57:00.170 the interoperability is the same. 57:00.170 --> 57:04.466 So, it becomes extraordinarily easier, simpler, 57:04.466 --> 57:07.790 sensical for the providers to look in the same 57:07.790 --> 57:09.540 electronic health record to see it. 57:09.540 --> 57:11.420 Would it have solved the problem for you son, sir? 57:11.420 --> 57:12.420 I don't know. 57:12.420 --> 57:15.120 And I apologize from the entire United States Military 57:15.120 --> 57:18.200 for what your family has gone through to get to this place. 57:18.200 --> 57:20.710 But tools support decision making 57:20.710 --> 57:23.510 and GENESIS will be a much better tool to support 57:23.510 --> 57:26.775 the clinicians who are taking care of people like your son. 57:26.775 --> 57:27.795 - [Man In Audience] Thank you. 57:27.795 --> 57:29.230 - So, unfortunately, 57:29.230 --> 57:31.600 thank you, sir, for answering that question. 57:31.600 --> 57:33.200 We're out of time. 57:33.200 --> 57:35.370 We'll be here on the side if anyone wants to talk 57:35.370 --> 57:37.410 and of course keep your questions coming 57:37.410 --> 57:38.800 and we'll make sure to answer them 57:38.800 --> 57:40.110 when Ms. Barron gets them to us. 57:40.110 --> 57:41.220 So, thank you for your time. 57:41.220 --> 57:42.973 I'll give it back to you, Ms. Barron. 57:42.973 --> 57:45.223 (clapping) 57:49.160 --> 57:51.510 - Well, that panel was well worth the wait. 57:51.510 --> 57:53.233 Thank you all so very, very much. 57:53.233 --> 57:56.150 Come back tomorrow morning at nine o'clock. 57:56.150 --> 57:57.216 Thank you. 57:57.216 --> 58:00.299 (audience murmuring)