- [Narrator] Funding for this edition of Think Tank with Steve Adubato has been provided by Robert Wood Johnson Foundation.

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[MOTIVATIONAL MUSIC] - Hi, everyone, Steve Adubato.

We kick off the program with an important healthcare, medical conversation with Dr. Anita Ramsetty, who is an endocrinologist and also Director of Health Equity at Englewood Health, one of our long time healthcare underwriters.

Dr. Ramsetty, great to see you.

- Appreciate it.

Time to talk.

- Yeah, it is time to talk.

Define "Health equity" for us, particularly, as we move into 2025, please.

- Sure.

So, yeah, health equity really has to do with fairness.

I talk a lot to different groups and I often point out, "By the time you get to about 18 years of age, you start to understand that life isn't always fair."

And it's the same with healthcare.

So we assume everyone has the same choices, the same opportunities, the same options, and that's really not the case.

So health equity really has to do with trying to level the playing field as much as possible, so that everybody has a fair chance to be healthy.

- Well said.

Could you tell us and break down this somewhat jargony phrase, "Social determinants of health," please?

- So this became really a lot more prominent over the last several years.

It was slow moving for a while, and then, over the last 10 years, it sort of exploded.

We always, for many years, thought that genetics really dictated how we did health-wise and there were some environmental component.

A lot of people were really into, what's my family history?

This is gonna tell me how healthy I'm gonna be.

And what we've learned in looking at where people live, where they work, where they interact with other people, those are really what the social determinants of health are, anything that's non-genetic is really what it is.

- Such as?

- Such as, the neighborhood that you live in, the job that you have, the education that you've had through your lifetime, the education of your family members.

- How about this?

- Money is really, really important.

Not in the traditional sense that a lot of people think about, but money gets you access to a lot of things, like your insurance, the groceries that you can buy, the transportation that you can afford, and all of those things will impact how you live and work through this world, and how you access healthcare as well.

And so, all of those will impact up to about 80% of your health, which surprises a lot of people.

- Let me ask you.

There are different initiatives at different healthcare organizations, but there is a Family Live Well Center at Englewood.

What's the name of it?

- Shirvan Family Live Well Center, yes.

- And what does it do, and who does it do it for?

- So our Shirvan Family Live Well Center, they're enjoying their one-year anniversary, similar to me, they opened their doors in October of 2024.

And, really, they are embedded in downtown Englewood on purpose, so that we have as much pedestrian and open access as possible within a public setting, it's not in a hospital.

It is essentially a place where people can access health-related classes as well as information that we often recommend to everybody.

There are mental health classes, there are physical health classes, there are maternal health classes, cooking classes, financial literacy classes, things that are open to the public free of charge for you to engage in, at any frequency that you would like.

- It's interesting, Bergen County... (coughs) Excuse me.

Is perceived by many to be one of the wealthier counties in the state and the nation.

- Mm-hmm.

- But there are pockets, pockets in Bergen County, where it's much harder to get access to the quality healthcare people need.

Explain that to folks.

- Now, this is pretty common in many places.

You know, the data that we look at is what I call aggregate.

It's the larger number of everything, it does not include all of the different pockets of neighborhoods, of streets, of districts.

And so, when you see those numbers, it's important to remember that they do not necessarily reflect everybody.

And that's true of any area that you look at, any zip code.

And so, yes, Bergen County is thought to be one of the more affluent areas of the entire country, certainly of New Jersey.

But within those areas, within different cultural pockets, immigration pockets, education pockets, neighborhoods, that predate when people possibly came to this country, or got here, or moved to the area that dictate how well those areas will do.

- So, let's try this.

We've been doing a whole range of work around maternal health.

- Mm-hmm.

- Talk to us about what maternal health really means, and what it really means for those who struggle to get access to the quality maternal healthcare they need.

Please, Doctor.

- There's a lot that goes into maternal health.

So we often think about that as a picture of a pregnant woman, pregnant person not potentially doing well, or having an outcome that's not the best.

And that, unfortunately, sometimes includes babies being born too early, or babies that don't make it after they have delivered, moms that don't make it after they have delivered.

And so, we often think about that.

The important thing to think about with maternal health is that this starts a lot earlier, and we are trying to turn the clock back in terms of what we try to get to.

This should be happening when people are starting periods, when they are teenagers, when they are starting to have relations where it could result in a pregnancy.

And those are critical times where nutrition's important, where education is important, when you need to understand exactly what you're getting into.

Recently, we found out that a number of people didn't really quite understand, well, yeah, after a certain age, you should be taking some supplements so that you have a healthy pregnancy.

Those are things that will affect a maternal outcome as well as the baby's outcome, but they're not widely known.

- Curious about this.

Your passion for this work comes from where?

- Oh (chuckles).

Sadly, it comes from realizing that, after years and years of medical training, which sometimes feels like a hundred years long, that what happened in my clinical office was not what was going to make the biggest difference.

I went through the typical years of college, medical school, my internal medicine training, my endocrinology training, and then had one patient that changed my life forever.

Because, in a conversation with her, I realized, "Okay."

She was eating essentially hot dogs most evenings with her grandson, who was the person that she was taking care of, both parents were not in his life anymore, and that was what she could afford.

She was doing the best that she could, and there was nothing that I could do besides offer her more medication, which would not fix it.

And that changed the course of my professional and personal life forever, because I thought, "What was the good of all of these years of training, if this woman will leave my office with two medications that will not help her.

Her blood pressure's not gonna get better, her diabetes is not gonna get better.

What she needs is support, taking care of her grandson, and better food."

- And so, therefore, you doing the work around health equity at Englewood is intended to impact a larger group of people on a greater scale?

Is that a fair way to say it?

- It is in two parts.

A lot of the work that I do is direct patient, it will directly impact patients.

For example, we try to ensure that everybody is able to make their appointments in ways that they prefer.

Hospitals, including ours, would love digital access for everybody.

Sounds great.

Not everybody has a cell phone, not everybody wants digital access, not everybody knows how to use it, not everybody can do it with their fingers.

So I'm trying to make sure that, when we're doing that, no patients are left out.

At the same time, there's a second half, which is making sure all of my colleagues, all of the medical staff also understands our limitations, and that we can adapt what we offer to patients so that it makes sense.

I used to tell the medical students that I taught, "You can't recommend salmon and quinoa to all of our patients with diabetes.

They can't always afford it.

It sounds great, but that's not practical.

So you need to think outside the box, and see what patients can do."

- Dr. Anita Ramsetty making a difference every day, Director of Health Equity at Englewood Health.

Doctor, thank you so much for joining us.

- Thank you very much for having me.

I appreciate your time.

- We appreciate your time.

Stay with us, we'll be right back.

- To watch more Think Tank with Steve Adubato, find us online and follow us on social media.

- Joining us now is Suzanne Kunis, President and CEO of NovaWell, and Vice President of Behavioral Health Solutions at Horizon Blue Cross Blue Shield of New Jersey.

A long time underwriter of public broadcasting.

Suzanne, good to have you with us.

- Great to be here, Steve.

Thank you.

- Talk to us about this quote unquote integrated approach to behavioral mental health.

What does that really mean?

- You know, the integrated care is really the goal that we all should have in terms of how we treat people in healthcare.

For example, my brain is part of the same body as my lungs, liver and heart.

And so too long, we've had people with behavioral health issues being treated over here and those with physical health issues being treated over here and never the twain shall meet.

And unfortunately that is not necessarily in the best interest of the patient, not the best outcome, and actually quite costly way of dealing with patients.

We need to treat people like people not a health condition.

- What is NovaWell?

- So NovaWell is a company that we established here at Horizon Blue Cross Shield of New Jersey.

I was hired about seven years ago to come in and really establish Horizon strategy around behavioral health.

And it really came down to what were the most important things for us?

And one of the biggest challenges we faced here in New Jersey for individuals with mental health issues and substance use issues?

And a couple of them are the following.

Integrated care, people are, they're such a fragmented system out there.

We talk about integration between physical health and behavioral health.

Well, there's still lack of integration just within behavioral health.

So it's really trying to drive all the agenda of integrated care, both within a health plan, making sure the culture is set up so that people understand that it is normal or okay not to be okay.

And that every one of us here has somebody in our life, whether it's ourself, a family member, et cetera, that has been impacted by a mental health or substance use issue and really trying to drive home that we need to change.

- Yeah.

- NovaWell was born as by virtue of the fact that we did a lot of work here in New Jersey to really change the dynamic around mental health and substance use.

And now we're trying it nationally.

- It's interesting, and I'm not alone.

There's so many millions of Americans who have family members dealing with a lot of the issues you're talking about.

But you keep talking about substance abuse and mental health.

Are they two separate issues or again, is the integrated approach that very often they are connected?

- Totally connected.

So not everyone with a mental health issue necessarily has a substance use issue, but most people with a substance use issue has some underlying anxiety or depression that's associated with their illness.

- So along those lines, given the fact that there is a shortage of psychiatrists, what the heck does a parent do?

What does one do if they're scrambling to find a psychiatrist who is a medical doctor, who can prescribe medication and a psychiatric social worker, a psychologist who is engaged in talk therapy talk about integrating and coordinating that, please, Suzanne.

- There are probably 10,000, give or take, warded child adolescent psychiatrist in this country.

There are well in excess of 15 million kids needing help.

So there is no way that the psychiatrists are gonna be able to cover the territory, so to speak.

And when you start looking at other disciplines, the thing we need to think about is it's gonna take the whole village to help our kids.

We are living in a time, you know, everybody thinks COVID had such a major impact on our kids and it did.

But this started a good 10 years ago when social media actually became so prevalent.

And so what we need to look at is how do we take that village?

How do we help parents to understand what it is?

You know, kids don't really have a lot of stigma around mental health, parents do.

We had to work with them around that.

How do we get the providers to speak to each other?

And not everybody has to be a licensed clinician.

There are so many extenders, if you will, within the behavioral health space that can really help to make a difference.

- What's an extender?

- So it could be somebody like someone who has lived experience, they call it peer support.

And so there are teenagers who are coming from families with lots of issues in mental health space.

It's really a matter of training individuals to be able to help, to support not only themselves but their friends, colleagues, et cetera, in a professional way, to really help to give 'em the support they need day in, day out.

- You know, we've been doing a whole range of work around youth mental health and we've featured the work of the Boys and Girls Clubs of America.

There is a connection here, talk about that, please.

- Oh, definitely.

So we're trying to find ways always to involve the community and look at how the community can help to build support services for kids and families.

And what better example than Boys and Girls Club?

The Blue Cross Blue Shield Association has committed nationally to a $10 million partnership and investment in our kids through the Boys and Girls Club and here at Horizon, we also have, as part of that contributed $300,000 over the course of several years.

And the whole idea is to train people within the Boys and Girls Club about trauma-informed practices.

- What does that mean?

Explain that.

- Sure, I will.

Trauma-informed practices is really trying to help those that are in front of these kids, understand the importance of listening to kids, demonstrating and role modeling the kinds of emotions and behaviors that we want our kids to exhibit.

Making sure kids have a safe place to go, make sure they have a place to go where they can speak to somebody.

It's really important to just have that location well educated around what it's gonna take to really support our kids as we move forward.

- Final question.

Some advice to parents, all of us who struggle to be helpful and can't fix it for our kids.

- So we've all been there, and in one way, shape, or form.

And we have so many examples of kids that have really struggled but, when there is truly the connection between a parent or guardian and these kids, you don't necessarily know what to do, but you need to know how to raise your hand and get help.

You can go online.

There are so many resources available online.

If you're a Horizon member, you have access to a platform called Horizon Mind Care, which gives you so much information about mental health, substance use, how to deal with issues of daily living with your kids.

And it'll actually give you an opportunity to connect immediately to virtual care that are specialists in child lesson services.

- None of this is easy.

- And- - No.

- Saying it takes a village is such an understatement.

Suzanne Kunis, President, Chief Executive Officer of NovaWell and also Vice President of Behavioral Health Solutions at Horizon Blue Cross Blue Shield of New Jersey.

A long time underwriter of public broadcasting and our work at the CEC.

Suzanne, thanks so much.

We appreciate it.

- Oh my pleasure.

Absolutely.

- You got it.

Stay with us, we'll be right back.

- To watch more Think Tank with Steve Adubato, find us online and follow us on social media.

- We're now joined by our longtime friend of the show, Tai Cooper, Chief Community Development Officer for the New Jersey Economic Development Authority, otherwise known as the EDA.

The website will go up right now.

Tai, how you doing?

- So far, so good.

Been a busy and productive year.

- You got this at the end of 2024, be seen in '25.

I'm gonna read you a quote from you.

You ready?

- (chuckles) I'm ready.

- We're talking about the cannabis industry.

Right?

- Let's go.

- From Tai Cooper, for something that people have had a stigma against, there was a great opportunity to discuss the medicinal use, but also the small business and community benefits of cannabis.

What the heck is going on with cannabis in New Jersey, A, and B, what does the Economic Development Authority have to do with it, please, Tai?

- So I would say a lot.

I mean, under Governor Murphy's leadership and also the legislature, New Jersey has really been at the forefront of the cannabis market.

For New Jersey in particular, specifically focusing on EDA, we launched some of the largest grants in the nation.

One of the things we immediately recognized is that there's huge barriers to entry when it comes to financing or funding.

And so the governor and the legislature authorized us to have up to $20 million to support cannabis businesses.

Now, I had to explain this to my mom as well 'cause she was like, "What are you doing?"

- Hold on, what is, what is your, hold on.

Your mom's work is in the field of what?

- My mom was a teacher, but she's a minister.

She's a minister.

- Oh, she's a minister.

And Tai, how did it go when you told her what you were doing with the cannabis industry?

- The same look you just gave me is the look my mom gave me.

But I have made her a fast believer in the benefits socially, also medicinally, of cannabis.

And specifically for EDA, we did an intentional focus on social equity candidates.

We had two products, one called Joint Ventures.

Do not laugh at the names.

And the other one called Seed Equity.

The Joint Ventures program provided grants up to $250,000 to cannabis businesses.

And this had to be for businesses that were established, had their locations, and were ready to go.

The governor was fantastic in supporting us also with CRC, and we were able to award 48 grants, 48 grants to different business owners, which is a huge deal.

- Hold on, Tai, back for a second, acronyms in government, CRC.

- The Cannabis Regul- - Cannabis Regulatory Commission?

- Yes, it is.

- Okay.

Go ahead.

- So they're the regulatory bodies.

They're the ones that dictate how things run, how they go forward, but they're also a really great partner to have as far as checks and balances.

And so working closely with the governor's office, with CRC, we launched these two grants.

One grant, as I said, Joint Ventures, was for $250,000.

The second grant was for $150,000.

And the one for $150,000 was specifically for those, for social equity candidates.

And those are for people that have been impacted by the war on drugs.

And so we wanted to level out the playing field by providing grants, not loans.

These are grants that go directly towards the small business user.

And I would say by the end of this year, we're gonna have 26 out of the 48 Joint Ventures businesses that are open and operating, and nine out of the social equity businesses that will be open, operating, and running.

That is huge.

- So Tai, I wanna follow up on that.

You keep referring to social equity, right?

Why is it disproportionately more difficult for cannabis business professionals, entrepreneurs who happen to be Black and brown, to break into this business and to make money?

- Well, I mean, as we stated earlier from my quote, there is a stigma that is attached to cannabis.

There's a stigma that's attached to BIPOC communities with cannabis being because there was a war on drugs targeting BIPOC communities, that stigma hasn't left.

And so what we're trying to do is really shift that narrative and put it on its head to show that if you invest in communities and communities of color through cannabis, you can have dramatic effects.

And again, one of the key things we noticed, that this is a time-intensive and money-intensive and laborious process to get involved in.

And so unless you've got $2, $3, $4 million just hanging around, it's really hard to break into this industry.

And so working with the governor's office, working with EDA and all of my colleagues, we created grant programs to again level that playing field.

And the reason we made one of the grants, Seed Equity, specifically for social equity candidates is because we recognize the disadvantages that come with having a criminal record.

You know, despite the attempts to get over it, there still is a stigma, and so what we're trying to do again is make sure that we provide resources in advance for businesses that are qualified, that have already gotten their approvals from CRC.

So it's not anybody.

You have to still go through a very rigorous process.

But we are there to hold your hand.

We're there to provide funding, and also there to uplift those communities.

- Got it.

Again, put the website up for EDA.

- Thanks.

- Economic Development Authority.

What, the A.R.T., A-R-T program, activation, revitalization, trans, transformation, I'll get that out, grant program.

$37 million pie For what and for whom?

- So huge initiative, and again, this is something that we thank the governor's office for and also the legislature.

One of the things that EDA has really recognized is that art is an economic driver.

Whether you look at the work that's happening at NJPAC, the work happening at Symphony Hall, you're watching how the arts and culture ecosystem is really lifting up communities.

And so what we were able to do is award grants.

We started with a small pilot program in both Newark and Atlantic City, and we're super awesome and super excited to be able to award these grants.

And it goes towards public transformation of spaces and real estate.

So if you think about blighted buildings, you can do a rehab on those buildings or murals.

These are things, again, which are small interventions, but have a huge impact on communities.

And so we were incredibly excited to do round one, again focusing on Newark and Atlantic City.

And we just rolled out, or just closed out A.R.T.

Phase II, which was only for public space entities, but was open to 35 different cities.

And again, this is recognizing the fact that nonprofits and art entities also have a space in economic development.

They are viable, they're resourceful.

And again, the beautification of our communities means that you're gonna drive folks to come back to our downtowns, back to our cities, and have something to also do.

So very supportive of the work the governor has supported through the arts as well.

- Tai, got about a minute left.

Play, excuse me, place-based, but also people-centered- - Yes.

- community development.

Real quick, what does that mean?

- (chuckles) It means that the governor, when he first got into office, had historic investments into people and into communities.

And again, when we think about community development, it is focused on people.

It's a very people-centered approach, and very place-based, meaning that you don't do development without having the people in mind.

It means that when we're working with our government-restricted municipalities, such as Atlantic City, Trenton, and Paterson, we're walking with them hand in hand, not just providing resources, but also providing financial stability behind them.

It means programs like our Asset Activation Program, which gives $50,000 in grants to help with pre-development issues like, so feasibility studies, market analysis.

So you're providing resources to communities that typically wouldn't have those grants available immediately at their disposal.

So again, when we talk about place-based and people-centered, we're putting people at the center of everything that we're doing when it comes to development.

- Tai Cooper, community, excuse me, Chief Community Development Officer for the Economic Development Authority, the New Jersey Economic Development Authority.

Their website has been up.

Find out more.

Tai, thank you, my friend, we'll have you back soon.

- Thank you so much.

Absolutely.

- You got it.

That's Tai Cooper, I'm Steve Adubato.

We'll see you next time.

- [Narrator] Think Tank with Steve Adubato is a production of the Caucus Educational Corporation.

Funding has been provided by Robert Wood Johnson Foundation.

Valley Bank.

The Turrell Fund, a foundation serving children.

Kean University.

New Jersey Sharing Network.

PSEG Foundation.

The North Ward Center.

PSE&G.

Powering progress.

And by NJ Best, New Jersey’s five-two-nine college savings plan.

Promotional support provided by NJBIZ.

And by NJ.Com.

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