Pandemic Impacts on Mental, Physical and Educational Outcomes for American Children: Welcome Remarks

SPEAKER: So I have the pleasure of introducing somebody who is absolutely amazing to do some level setting and talk to us about why we're here. So Dr. Patrice Harris is the CEO and co-founder of eMed, a digital health care company.

She's a board-certified psychiatrist from Atlanta and has diverse experience as a private practice physician, county public health director, and patient advocate. She has deep experience and expertise in public policy on both legislative and regulatory fronts and at all levels of government.

Dr. Harris was the 174th president of the American Medical Association, the first African-American woman elected to that position. Please clap.

She is vice chair of the West Virginia University Board of Governors and chair of the search committee to select the next president. She serves on the board of United Bankshares, Incorporated. She spent her formative years at West Virginia University, earning a Bachelor of Arts in psychology and a master's in counseling, psychology, and ultimately an MD.

She completed her residency and fellowship training in child and adolescent psychiatry and forensic psychiatry at Emory University School of Medicine. And finally, she's also a member of Alpha Kappa Alpha Sorority, Incorporated. I now welcome Dr. Harris.

PATRICE HARRIS: Good morning, everyone. I think I have some slides up. I'm going to stand behind the mic just for my slides. And then I'll come out for a few questions.

I'm just going to do, I think-- have someone coming up right now and pulling up the slides. And the reason why he's coming up right now is I sent them this morning at 6 o'clock, so you know how that works.

So let me thank you all for having this conversation. And I know we have folks who are watching virtually as well. So it's been in conversation for a year, but it's such an important conversation. So I really appreciate you all giving the platform for this because I worry a lot that, although there were many lessons we should learn from COVID, I worry if we are really learning those lessons.

And I think a part of the conversation and the lessons learned surround educating our children and also connecting the dots between what's going on in our educational system and our health care system and our economy. They are all so connected and interrelated.

And so I think today is a very important opportunity to connect some dots. And I just want to do a little bit of context-setting and really think about the opportunity we have as leaders, again, in this room and watching virtually, to connect the dots, really, but connect the dots in the service of change-making and solving problems and really looking around how we educate our children going forward.

During the pandemic, as you just heard, I was president of the AMA. Dr. Sally Goza, a pediatrician from Georgia, was the president of the American Academy of Pediatrics. And one more tidbit, probably useless piece of information, Dr.-- and I should have written this down. I'm going to remember her name. Jackie is going to kill me. But she was president of the Georgia-- I mean, I'm sorry, the American Academy of Family Medicine.

So we had three women physicians from Georgia who were all in charge during COVID. But Sally and I co- authored an op-ed. And it was "Who Has Eyes on the Children?" Because as you recall early in the pandemic, of course, most of the folks who were hospitalized and losing their lives were seniors, chronic disease, communities of color. And we appropriately focused on that.

But being a child psychiatrist and Sally, being a pediatrician, we wanted to make sure that, in the midst-- and this is the context-setting, because it is easy to be focused-- and we should be laser focused on maybe the problem that's right in front of us. But as we are laser focused on that, we can't forget the context.

And that's why context is always important. And so I'll do a little bit of that this morning and try to connect the dots again about change-making and leadership and advocacy. And just quickly, it's about purpose and community.

And I'm born and raised in West Virginia, did all of my training there. And I was asked not too long ago to come up with a six-word memoir. And at first I was grumbling. Sometimes I hate those kinds of exercises. But actually, I ended up having fun with it, and it came to me really quickly.

And it was, "My purpose in life is to climb mountains, to give voice." And that's a little bit of play on West Virginia and the mountains of West Virginia, but also my journey to become a physician, which was not always easy. But that's a topic for another day.

And of course, my original inspiration was Marcus Welby. And everyone in the room looks much younger, so you have to Google that. But Marcus Welby was, I guess, my generation's Grey's Anatomy. We were just talking about old fogey alerts. Again, another conversation for another day about the ability to peek around, I say, corners and even peek around decades.

I think we should probably not try to peek around centuries too far ahead. But we should be thinking about this. And really, that's a part of this conversation today.

But here I was right around the corner up at the Hyatt in June of 2019, as I was inaugurated as the 174th president of the AMA. And I was able to, again, have the opportunity to give voice to a lot of things with this position.

Little did I know that about seven months later-- because this was, again, June-- that we were going to be confronted with something that we hadn't seen in a century. And of course, that was the COVID-19 pandemic.

And this is not Atlanta, because I'm a homer, so wouldn't just show the horrible traffic in Atlanta in any presentation. But if you think about the health care system-- and by the way, for any economists in the room-- and I know we're here at the Federal Reserve-- I hope I don't have to still convince you how intertwined health care and the economy is.

Pre-COVID, may have had to have a conversation. But I did a lot of presentations for the business community during COVID because I think sometimes businesses, again, I believe, pre-COVID may have thought, well, my interest in COVID is making, sure, my employees are healthy and maybe purchasing and figuring out the plans, but not really the interconnectedness that I hope many people see now.

So pre-COVID silos, fragmentation, which direction were we going, and even with the passage of the Affordable Care Act-- and certainly, COVID put all of these issues on hyperdrive and highlighted for some-- not for many. Some of us knew this already-- health issues around health inequities, issues around the fact that the public health infrastructure-- again, public health had been defunded and underfunded over decades.

We're talking about mental health today. And there's no question that our infrastructure around mental health has been underfunded and defunded. And so COVID just, again, highlighted many of these issues.

We saw, pre-COVID, increasing rates of suicide among adolescents and young folks and then the inequities there when you look at some communities of color and certainly increased reporting of symptoms. And I'm going to just stick a pin in this. We could have a whole other conference about social media and the impact social media has. But it's all related, interconnected.

And so if you don't remember anything else I say today, just think it's always important for us to connect the dots and look at the opportunities for making sure that we are working collaboratively to address a problem. And we can't just address a problem in its silo or in isolation of anything else.

And then something else reared its ugly head. Misinformation, right? And disinformation. And if you ask me that-- the one thing, of course, lots of things keep me up at night. They used to joke at the AMA that some of the other board members would say, we don't have to worry about anything because Patrice worries enough for all of us.

So we don't have to worry about it, because we know she's worried about it. And that is probably true. But what really worries me a lot at night is where we are regarding misinformation and disinformation. And again, during COVID, I actually did a national address.

We saw this early. So March or April the AMA partnered with the Press Club in DC. And we did a national address on misinformation and disinformation and the truth and the facts and science and evidence, because we saw early on, the direction that, unfortunately, we were going in.

And we knew that we were not going to be able to solve this problem without some focus on facts. And so, again, this is what worries me. And this is another reason-- I've probably given you 10 already-- why meetings like this are important.

You're going to hear from folks who are looking at the data, studying the data, bringing the data forth, talking about their conclusions. And we will have conversations about those conclusions. But the good news is, in this room and the virtual room, these conversations will be intellectually honest.

And so, again, leadership is required. Again, great modeling here. And today, I always say, when you're lost-- when you get to the airport-- and I will admit that the Atlanta airport is huge and very busy. But when we are lost, what do we do? We find one of those wayfinding signs.

And so I think that meetings like today, conversations like today, and others we will have are a way to say, all right, let's take a deep breath. Here we are. Let's look at the sign. And a wayfinding sign, it does tell you where you are. But it also gives you the context around you. And you can see where you want to go.

So I think that, again, we are doing this today with a conversation for looking at-- and particularly around children. Because again, with that op-ed "Who has Eyes on the Children?"-- and I'm biased. I'm a child psychiatrist. We need to make sure that we don't forget about our children.

Yes, children are resilient. But we should always focus on our children. And so one of the things that I had the privilege of doing is leading the AMA's Opioid Task Force when I was on the board there. And again, sort of being overwhelmed about huge problem around opioids in this country.

And I remember saying, all right, let me get centered and figure out a framework. So this is a framework that I developed. And I realized that, for me-- and this is my individual framework, although I think there are lessons to be learned. Let's make sure we have conversations with these three principles in mind that we will require evidence.

So if someone comes up to me and says it is 200 degrees outside, I am not going to even engage in that. Because first of all, when I looked at my app this morning, the evidence is clear. And I think if all of us pulled up our weather apps, there may be some 2 to 5 degrees of difference. But it is not-- no one's weather app, if it's a credible weather app, is going to say it's 200.

And so I also require intellectual honesty in this room, the virtual room. Don't have to worry about that. But in the larger context, we know that folks don't always come to conversations around intellectual honesty.

The one thing I do regret-- well, I regret maybe a couple of things in COVID, but I did participate in one conversations where not everyone was committed to that. And it was a mistake. You can't-- and winning isn't even the goal unless you're just winning on making sure people get good, accurate information and then use that information to make decisions.

And then just the context around as we think about children and education. But certainly, that is in context with community, the community that they live in. And certainly, if you're designing solutions for a community-- we were talking earlier about private school.

But I even used to use this example for the opioid epidemic, in that the solutions that might work in my home state of West Virginia won't be the solutions that will work in Marin County. And I was on a panel or attended a meeting where there was a panel of folks who were thinking about this in Marin County. But both are addressing the issue. But the solutions are different.

And so we always have to understand the context. And so here's what we'll learn today and I learned during COVID. It's important to disaggregate the data. I think heretofore we've done a lot of lumping. And we have to be committed to splitting.

Now, at the beginning, you may have to solve a problem. Let's see where we are. What's the big picture, the wayfinding. But then it's important-- and I think one of the reasons we were able to quickly see the impact on communities of color during COVID was because some of the early states had that data. And so the data was disaggregated.

And I think that we should-- and you will hear this. I, of course, had a preview of what we're going to hear today. Precision with questions. Again, the first question could be broad. But then we have to get precise when we are asking these questions.

And we may have to-- and there's limits to this. We want to solve these big problems. But it may be that you have to ask the question around Chicago schools and not schools across the country. And so when you ask a more precise question, you have to make sure that we are also precise in our conclusions and that we don't make these broad conclusions about that.

What we can say-- if you've studied the Chicago Public School system and the youth in there, you can say a lot about that. And then we can think about how that may relate to schools in Atlanta, the children and the school system in Atlanta, how that could be extrapolated, but not necessarily.

We have to be just be real precise about our conversations. We have to say what we don't know. We have this data. We have this study. Here's what we can say with some reasonable certainty. But here's what we don't know.

And that's hard. And I think if you look back at COVID, there was a bit of a challenge. We didn't know a lot. And we were making decisions. And by the way, I think the decisions-- we were making decisions. But what we didn't say was we were making decisions based on this data. The data may change tomorrow. We may have to make some decisions.

And the question that I have to say-- getting back to the one thing that we're going to discuss today, and I want to end up here in just a minute. And please, someone challenge me on this, but asking-- the whole debate around should we close schools or not was-- I get a little frustrated with that question.

At the very beginning, we had to close schools, right? We didn't know enough about it. And then what do we need to do? No one sort of said, well, what do we need to do to reopen? And here's the pathway. And here's the roadmap.

And then, of course, we didn't ask that question. And some people asked the question then. Folks weren't willing to do that. What they were willing to do is argue about the either/or-- open schools or closed schools, which one was right. Either/or.

Of course, that's not going to happen today because we have reasonable people who are reasonably informed. But I always push back. And when I'm talking to students, I say, someone gives you an either/or or asks you, is it this or is it that, run. We have to have nuance when we have these conversations.

This is just one of my favorite slides about the health care system. But I think that we could just make this about any system, the school system, and really just make the point about the interconnectedness, the importance of leaders.

We can't forget about trust as we go through this and present data and have these conversations and bringing in folks who have earned trust. We can't forget about coffee. I had mine early this morning. Maybe not for everyone, but whatever gets you going.

Take a deep breath as we have these conversations and try to solve problems that-- because at the end of the day, particularly this problem-- we are talking about children's health and their education and how that relates.

One of the things that some people knew in addition to the other issues about health inequities and public health and behavioral health-- who knew that our schools-- I imagine everyone in this room did-- were such an important cog in the wheel of our country? Who knew that?

People were able to understand that. Some people got their only meal of the day. Some kids got their only meal of the day at school. Parents are able to go to work because we have a functioning school system. Child care, another conversation for another day.

And so these are all, again, issues that were brought to the fore with COVID. Tough issues, but you know what? People ask me a lot if I had hope. This was my last address at the AMA, June of 2020, as I was outgoing president.

But again, people often ask me if I had hope. And I said, I do have hope. But it's hope because people like the people in this room and what you're doing here, bringing these conversations, bringing people together, convening these meetings so we can have informed conversations that will spur us to action.

Many of us have heard, hope is not a strategy, and that is true. But hope is part of a strategy, along with everything we'll learn today, being informed, being educated, participating in meetings like this. So thank you very much for the opportunity to set the context for this morning. And I know I'm over time.

So we'll go on to the next panel. And I'll be around on another panel. And folks can ask me questions. And so thank you very much.