>> COMING UP ON CYCLE OF HEALTH, DR. RICH O'NEILL AND A PANEL OF EXPERTS ADDRESS YOUR TOP-OF-MIND QUESTIONS ABOUT PUBLIC HEALTH CONCERNS, AND DISCUSS HOW DISINFORMATION CAN BE A SOCIAL DETRIMENT TO HEALTH AND WELLNESS AND WELLNESS IN OUR COMMUNITIES.

>> WHEN PUBLIC HEALTH WORKS AND WORKS WELL, NO ONE HEARS ABOUT IT.

JUST BECAUSE YOU DON'T HEAR ABOUT IT, DOESN'T MEAN YOU SHOULDN'T VALUE IT.

>> AND LATER IN TODAY'S MEDICAL STUDENT MINUTE, OLIVIA LANIAK TELLS US HOW TO SPOT SIGNS OF A STREP THROAT.

THAT'S COMING UP ON CYCLE OF HEALTH.

DON'T GO ANYWHERE.

>> HELLO, WELCOME TO CYCLE OF HEALTH.

I'M YOUR HOST, DR. RICH O'NEILL.

TODAY'S TOPIC: CREATING A PUBLIC HEALTH DISASTER?

OR JUST TRIMMING THE FAT FROM A BLOATED HEALTHCARE BUREAUCRACY.

AROUND 1800, ABOUT HALF OF BABIES LIVED TO ADULTHOOD.

ADULTS ON AVERAGE LIVED TO ABOUT 40.

THEN CAME SCIENCE WITH UNIVERSITIES AND PUBLIC HEALTH AGENCIES, RESULTING IN CLEAN WATER, HEALTHY FOOD, VACCINES, FLUORIDE, ETC.

NOW, IN 2025, OUR BABIES HAVE A 95% CHANCE OF BECOMING ADULTS, AND THE AVERAGE ADULT LIVES TO ABOUT 80.

BUT NOW, OUR UNIVERSITIES AND PUBLIC HEALTH AGENCIES ARE BOTH BEING CHAINSAWED, AND PERHAPS THE GREATEST THREAT TO OUR HEALTH, DISINFORMATION SURROUNDING SCIENCE AND OUR HEALTH IS SPREADING LIKE POLIO ONCE DID, THREATENING TO TAKE US BACK TO THE DARK AGES.

WHAT TO DO?

TO HELP US ANSWER OUR QUESTIONS ARE DR. KATIE ANDERSON, HEALTH COMMISSIONER AT THE ONONDAGA COUNTY HEALTH DEPARTMENT; DR. BRITTANY KMUSH, ASSOCIATE PROFESSOR OF PUBLIC HEALTH AT SYRACUSE UNIVERSITY; AND DR. JAMES MCDONALD, HEALTH COMMISSIONER AT THE NEW YORK STATE DEPARTMENT OF HEALTH >> WELL, FOLKS, WITH THE PRESIDENT AND THE NEW SECRETARY OF HEALTH, KENNEDY, WHAT IS THE IMPACT OF DESTROYING THE TRUST OF THE PUBLIC IN WHAT THE GOVERNMENT SAYS ABOUT HEALTH?

>> YOU KNOW, SO A TRUST IS A CURRENCY OF LIFE.

I HAVE A TRUST RELATIONSHIP WITH ALL 20 MILLION NEW YORKERS HERE AND I THINK ABOUT, YOU KNOW, AS THE STATE HEALTH DEPARTMENT, WE ARE A VENERABLE HISTORIC INSTITUTION.

WE SIMPLY CAN'T RESPOND TO EVERY ODD FACT THAT'S OUT THERE.

WAS WE DO DO THOUGH IS WE PROVIDE OBJECTIVE TRUTH ALL THE TIME.

WHATEVER THE TOPIC IS, WE TELL YOU THE TRUTH.

WE HAVE NO INCENTIVE OTHER THAN TO TELL YOU THE HONEST TRUTH ABOUT EVERYTHING.

>> SO WAIT A MINUTE, YOU ARE NOT JUST SITTING AROUND EATING BON-BONES FIGURING OUT HOW TO WASTE TAXPAYER MONEY.

>> THERE ARE NO BON-BONES AT THE STA-- >> NO I'M NOT COMING TO YOUR OFFICE.

>> MORE COOKIES THAN THERE SHOULD BE.

WHEN YOU ARE A STATE HEALTH DEPARTMENT, OUR MISSION, PROTECT AND PROMOTE THE HEALTH AND WELL-BEING OF ALL BUILT ON A FOUNDATION OF HEALTH EQUITY.

WE ARE IN IT FOR EVERYONE ALL THE TIME.

>> SO ARE YOU, IS NEW YORK STATE STATE DEPARTMENT OF HEALTH GOING TO HAVE OR BECOME OR ALREADY IS A PLACE PEOPLE CAN GO AND FIND TRUSTWORTHY INFORMATION ABOUT THE NEXT PROBLEM?

>> YEAH, SO WE ARE.

WE HAVE BEEN AND WE ALWAYS WILL BE.

THAT IS WHAT A STATE HEALTH DEPARTMENT HAS TO BE.

ONE OF THE THINGS THAT'S GREAT ABOUT THE NEW YORK STATE DEPARTMENT OF HEALTH, I GET TO BE YOUR DOCTOR.

THE GOVERNOR IS NOT TELLING ME WHAT TO SAY.

I SUPPORT THE GOVERNOR IN EVERYTHING SHE DOES BECAUSE SHE IS A GREAT ADMIRABLE PERSON TO WORK FOR, BUT SHE LETS ME RUN MY STATE HEALTH DEPARTMENT.

NOT EVERY HEALTH COMMISSIONER CAN SAY THAT.

>> SO ON THE COUNTY LEVEL, SAME QUESTION, ARE YOU GUYS A TRUSTWORTHY SOURCE OF INFORMATION?

CAN PEOPLE COME TO YOUR WEBSITE TO GET INFORMATION.

>> TRUST HAS TO BE EARNED.

IT'S PART OF OUR MISSION TO GET OUT AND BE PART OF THE COMMUNITY AND BE INTEGRATED INTO THE COMMUNITY.

WE EXPECT NOW AND GOING FORWARD, ACCESS TO RELIABLE INFORMATION IS GOING TO BE MORE AND MORE IMPORTANT BECAUSE WHAT WE WORRY ABOUT AT THE LOCAL LEVEL AND STATE AND FEDERAL LEVEL IS THE CONSEQUENCES OF HOW THIS MISAND DIS INFORMATION MIGHT IMPACT PEOPLE'S DECISIONS WHETHER OR NOT THEY'RE GOING TO VACCINATE THEIR CHILD; WHETHER OR NOT THEY MAY INSTALL A RELIABLE SEPTIC SYSTEM.

ALL THESE CORE ASPECTS OF PUBLIC HEALTH THAT HAVE REAL CONSEQUENCES BECAUSE THE THINGS WE ARE TRYING TO PREVENT ARE THINGS WE DON'T SEE DAY TO DAY BUT THEY'RE THERE AND THE IMPACTS WILL BE FELT SO THE ONUS IS ON US AND THE URGENCY IS THERE TO MAKE SURE THE PEOPLE UNDERSTAND THE EVIDENCE, THE LONG HISTORY OF WHY THESE ADVANCES ARE SO IMPORTANT IN PUBLIC HEALTH AND THE CONSEQUENCES OF THE DECISIONS.

>> YOU ARE AN ESPECIALLY DEEM EPIDEMIOLOGIST, SO-- YOU ARE AN EPIDEMIOLOGIST AND YOU KNOW SOMETHING ABOUT THE SCIENCE AND FACTS AND VACCINES, FOR INSTANCE.

WHAT ARE THE FACTS ABOUT VEES?

WE HEAR-- VACCINES.

WE HEAR A LOT OF STUFF FROM SECRETARY KENNEDY AND ET CETERA.

WHAT ARE THE ACTUAL FACTS.

>> THE FACTS ARE THAT VACCINES ARE ONE OF THE MOST SAFE AND EFFECTIVE TOOLS THAT PUBLIC HEALTH PROFESSIONALS HAVE TO PREVENT INFECTIOUS DISEASES THAT HAVE SEVERE CONSEQUENCES FOR HEALTH AND THEY'RE VERY RIGOROUSLY STUDY STUDIED AND TESTED FOR SAFETY AND EFFICACY.

>> I DON'T WANT TO SAY THIS OUT LOUD BUT WHEN I WAS A KID, I REMEMBER PICTURES IN LIFE MAGAZINE OF KIDS IN IRON LUNGS FROM POLIO.

AND MY WIFE AND I ACTUALLY HAVE A FRIEND WHO IS POST POLIO.

SHE HAD POLIO WHETHER SHE WAS A KID.

AND SHE IS NOW DYING OF SOMETHING CALLED POST POLIO.

WHICH I DIDN'T KNOW ANYTHING ABOUT.

BUT IT HAS LINGERING EFFECTS LIKE 50, 60, 70 YEARS LATER.

SO THE VACCINES PROTECT AGAINST THAT.

AND COMPARED TO THE CONTROL GROUP OF PEOPLE WHO DON'T GET THE POLIO VACCINE, FOR INSTANCE, HOW MUCH BETTER OFF ARE PEOPLE WITH GETTING THE VACCINE?

>> YOU ARE EXPONENTIALLY BETTER OFF TO GET THE VACCINE.

THEY'RE SAFE, VERY EFFECTIVE PEOPLE FORGET BECAUSE VACCINES ARE SO EFFECTIVE, MANY PEOPLE HAVE NOT SEEN A CASE OF POLIO, A CASE OF MEASLES AND HOW SEVERE THOSE INFECTIONS CAN REAL BE.

AND THE LONG-TERM SIDE EFFECTS.

>> NOT JUST PEOPLE BUT DOCTORS, TOO.

MOST PHYSICIANS GO THEIR ENTIRE CAREER WITHOUT SEEING A CASE OF POLIO.

>> IN THIS COUNTRY.

>> AND LIFE IN GENERAL, WE DON'T SEE THESE VACCINE PREVENTIBLE DISEASES SO WE TAKE THEM FOR GRANTED.

AND THIS GETS TO THE POINT OF LIKE I GOT THE POLIO VACCINE WHEN I WAS A BABY.

I DON'T WORRY ABOUT THAT.

SAME WITH ALL THE OTHER VACCINES I GOT.

AND I THINK THIS REALLY GETS TO THAT POINT.

I'VE BEEN A PEDIATRICIAN FOR 35 YEARS.

I KNOW I DON'T LOOK THAT OLD.

THANK YOU.

BUT IT REALLY UNDERSCORES THE POINT THAT ONE OF THE THINGS I FIND IS WHO IS INFLUENCING THE PARENT?

BECAUSE THAT'S WHO IS MAKING THE DECISION, RIGHT?

AND IT'S REALLY INTERESTING.

IT'S USUALLY NOT THE DOCTOR.

IT'S EXTERNAL SOURCES BECAUSE WE HAVE BEEN TRAINED.

WE UNDERSTAND THAT MOLECULAR BIOLOGY, THE PHARMACOLOGY, WE KNOW HOW THE VACCINE WORKS.

WE ARE THERE.

BUT WHEN YOU HAVE ELK TERM INFLUENCES THAT ARE NOT EXPERTS, PEOPLE GET LEGITIMATELY CONFUSED AND DON'T KNOW WHO TO TRUST.

BACK TO MY EARLIER POINT.

TRUST IS THE CURRENCY OF LIFE.

>> SO YOU HEAR FROM YOUR NEIGHBOR OR THE MOTHER NEXT TO YOU IN THE LINE AT THE DAYCARE CENTER.

I'M NOT GIVING MY KID THOSE VACCINES BECAUSE THEY'RE GOING TO CAUSE AUTISM, RIGHT?

WHICH I THINK WE ABSOLUTELY KNOW THERE IS NO EVIDENCE WAS SO EVER VACCINES CAUSE AUTISM.

>> IT HAS BEEN REPEATEDLY AND SOUNDLY DISPROVEN.

>> AND THEY'RE EMPLOYING SOME NEW GUY AT THE WHATEVER, THE HEALTH AND HUMAN SERVICES WHO IS GOING TO TRY TO PROVE THAT IT IS.

>> WELL STUDIED IN MULTIPLE COUNTRIES TOO, BY THE WAY.

Dr. ANDERSON IS EXACTLY RIGHT.

VACCINES DO NOT CAUSE AUTISM.

BUT THIS IS AN ISSUE AND THE QUESTION HAS BEEN WELL STUDIED IN MULTIPLE COUNTRIES SEPARATELY.

AND I THINK WHY THAT IS IMPORTANT IS AUTISM IS A SIGNIFICANT PUBLIC HEALTH ISSUE.

RICH, I HAVE THREE KIDS, TWO HAVE DIFFERENT FORMS OF AUTISM.

THEIR AUTISM DIDN'T COME FROM VACCINES.

IT COMES FROM OTHER REASONS OFTEN UNKNOWN AND IT'S CALLED AUTISM SPECTRUM DISORDER FOR A REASON.

THERE IS A WIDE VARIATION OF HOW KIDS ARE AND ONE THICK I CAN TELL YOU, SOME KIDS DIAGNOSED WITH AUTISM MANY DECADES IN MY CAREER LATER WERE FOUND OUT TO HAVE SOMETHING ELSE BECAUSE NEW TECHNOLOGY SHOWS IT IS ACTUALLY A DIFFERENT DISEASE.

LIKE MOST PEOPLE DON'T KNOW ABOUT LANDAU CLEFNER SYNDROME.

PEOPLE THOUGHT IT WAS AUTISM BUT IT'S NOT BECAUSE IT WASN'T DISCOVERED THEN MUCH THAT'S THE POINT.

AUTISM SPECTRUM DISORDER IS A SERIOUS PUBLIC HEALTH PROBLEM.

BUT YOU LEARN ABOUT SERIOUS PUBLIC HEALTH PROBLEMS WHEN YOU STUDY THEM, NOT WHEN YOU GO DOWN BUNNY TRAILS THAT LEAD YOU NOWHERE BECAUSE THERE IS LIMIT PUBLIC RESEARCH DOLLARS.

YOU CAN'T SPEND THEM ON THINGS THAT AREN'T GOING TO GIVE YOU LEGITIMATE QUESTIONS AND WHEN SOMETHING SETTLED SCIENCE, IT IS BEST TO MOVE IT TOWARD UNKNOWN SCIENCE AND LEARN MORE.

>> SO SPEAKING OF OTHER COUNTRIES, AND DATA FROM OTHER COUNTRIES, YOU KNOW, THERE HAS BEEN A RECENT OUTBREAK OF EBOLA IN AFRICA AND JUST IT WAS JUST FOUR OR FIVE YEARS AGO WHERE THERE WAS AN OUTBREAK, IT WAS SO TERRIFYING, WE BROUGHT ONE PERSON BACK FROM AFRICA AND IT VIRTUALLY CLOSED DOWN THE COUNTRY.

WHAT DOES NEW YORK STATE DO IF THERE IS AN OUTBREAK OF EBOLA NOW THAT THE U.S. AID DOLLARS TO HELP CONTAIN THAT ARE BEING SLASHED.

>> LET'S TALK ABOUT HOW THAT WORKS BECAUSE WE DID HAVE AN EBOLA ISSUE IN NEW YORK STATE 10 YEARS AGO, RIGHT?

SOMEONE ACTUALLY HAD BOO L IN NEW YORK STATE.

TREATED AT BELLEVUE, SUCCESSFULLY CURED.

BIG DEAL BUT RICH YOU ARE A SMART GUY BUT I BET YOU HAVE NEVER HEARD OF-- >> YOUR DIAGNOSTIC ABILITIES ARE GETTING QUESTIONED.

>> THERE YOU GO.

RIGHT?

BUT EBOLA IS A VIRAL HEMORRHAGIC FEVER MARBURG VIRUS IS A HEMORRHAGIC VIRUS WHY IS THAT RELEVANT TO THE CONVERSATION.

MOST PEOPLE HAVE NEVER HEARD OF IT.

LAST YEAR THERE WAS A MARBURG VIRUS OUTBREAK IF AFRICA.

HERE IS WHAT HAPPENED.

WORLD HEALTH ORGANIZATION GETS INVOLVED.

THEY WORK WITH CENTERS FOR DISEASE CONTROL AND PREVENTION, GET LOCAL BOOTS ON THE GROUND THERE.

CDC IN ATLANTA SENDS PEOPLE OVER TO AFRICA, TRAVEL DIRT ROADS, BRING, YOU KNOW, VACCINE AND CLINICAL TRIAL, BRING THERAPEUTICS AND CLINICAL TRIALS AND PROTECTIVE EQUIPMENT.

CDC INTERACTS WITH THE STATE HEALTH DEPARTMENTS WE KNOW PEOPLE ARE COMING IN THE UNITED STATES, WE ISSUE A TRAVEL ADVISORY.

WE TELL LOCAL HEALTH DEPARTMENTS WHAT IS GOING O.

EVERYBODY KNOWS WHAT IS GOING ON.

NO CASES LEFT AFRICA.

WHEN CDC WAS THERE WITHIN NINE DAYS, THE FIRST DOSE OF VACCINE WAS GIVEN.

OVER A THOUSAND PEOPLE WERE VACCINATED.

YOU KNOW AND THIS IS A GOOD EXAMPLE WHEN PUBLIC HEALTH WORKS AND WORKS WELL,NO ONE HEARS ABOUT IT.

AND I THINK THIS IS ONE OF THE THINGS ABOUT PUBLIC HEALTH IS JUST BECAUSE YOU DON'T HEAR ABOUT IT, DOESN'T MEAN YOU SHOULDN'T VALUE IT.

BECAUSE WHAT YOU SHOULD VALUE IS YOU GET TO LIVE LIFE WITHOUT WORRYING ABOUT SOME OF THESE PUBLIC HEALTH PROBLEMS.

I SEE YOU Dr. ANDERSON VIGOROUSLY NODDING YOUR HEAD NOT JUST BECAUSE HE IS YOUR BOSS AND YOU HAVE TO BE NICE TO HIM.

SO WHAT ARE YOU THINKING ABOUT THIS?

>> I AGREE, I HAVE BEEN IN MY POSITION FOR TWO YEARS.

WHEN I CAME INTO THE JOB I HADN'T FULLY UNDERSTOOD THE VAST COPE OF WHAT THEY DO THAT WE NEVER HEAR ABOUT, MAKING SURE WATER IS SAFE TO DRINK, MAKING SURE RESTAURANTS ARE SAFE TO EAT IN, SEPTIC SYSTEMS, VACCINES, STDs, MATERNAL CHILD HEALTH.

VAST ACTIVITIES THAT ARE CRITICALLY IMPORTANT FOR OUR COMMUNITY BUT PEOPLE DON'T KNOW AND MOSTLY THAT'S OKAY.

WE DON'T NEED PEOPLE TO BE APPLAUDING US EVERYWHERE WE GO.

BUT WE NEED THEM TO VALUE WHY IT'S SO IMPORTANT TO HAVE SAFE, CLEAN WATER, WHY IT'S SO IMPORTANT ON THAT CHILDREN ARE VACCINATED AND FOLLOWING UP ON WHAT Dr. McDONALD WAS SAYING, INFECTIOUS DISEASES FOR ME IN PARTICULAR, THEY DON'T RESPECT BORDERS.

SO WE DON'T KNOW IF THE NEXT PROBLEM TO CUP, GOD FORBID, TO THE UNITED STATES WILL BE MARBURG EBOLA.

IT COULD BE SOMETHING ELSE BUT TURNING A BLIND EYE FROM CDC AND SO THAT'S GOING TO BE AFFECTED MOVING FORWARD AND IT'S A GREAT EARLY WARNING SYSTEM, RIGHT?

YOU CAN TEST THE WASTE WATER, SEE WHAT IS GOING ON IN THE COMMUNITY.

OFTEN BEFORE WE ARE REALLY HAVE A LOT OF CLINICAL CASES IN ORDER TO DIAGNOSE PEOPLE.

>> I REMEMBER WE HAD SOMEBODY ON THE SHOW TALKING ABOUT THAT AND THEY WERE ABLE TO DETECT ONE CASE OF CORONAVIRUS IN 10,000 PEOPLE THROUGH THE WASTE WATER.

AND THAT WAS JUST SHOCKING.

WHAT A GREAT EXAMPLE OF HOW SCIENCE, TO ME, JUST AMAZING AT TIMES.

AND Dr. ANDERSON, I KNOW THE COUNTY SPENDS A LOT OF TIME AND ENERGY AND PROBABLY MONEY ON LEAD, GETTING RID OF LEED IN OUR COMMUNITY.

WHERE DO THINGS STAND THERE.

>> THAT'S ONE OF OUR BIGGEST AND MOST CHALLENGING PUBLIC HEALTH PRIORITIES IN THIS AREA.

SYRACUSE IS NOT ALONE IN THIS STATE IN HAVING VERY OLD HOUSING STOCK.

MOST OF OUR HOUSES WERE BUILT BEFORE 1978 WHEN LEAD PAINT WAS BANNED.

WE HAVE A LOT OF RENTAL IENTS WHICH ARE PARTICULARLY HARD TO MAKE SURE THEY'RE UP TO CODE AND WE UNFORTUNATELY HAVE ZIP CODES IN OUR CITY WHERE A HIGH PROPORTION OF KIDS ARE LEAD POISONED AND THAT IMPACTS THEIR LEARNING AND FUTURE TRAJECTORY AND IT'S REALLY CHALLENGING JUST BECAUSE OF THE SHEER AMOUNT OF HOUSING.

SO THINGS THAT WE ARE TRYING TO DO, WORKING WITH LOCAL PARTNERS, MAKE SURE CHILDREN GET TESTED.

A LOT OF THESE KIDS WHO LIVE IN ZIP CODES MOST IMPACTED MAY FACE MULTIPLE CHALLENGES AND BENEFIT FROM MULTIPLE PROGRAMS.

INCREASED ACCESS TO NUTRITION, INCREASED ACCESS TO TESTING, LEAD ABATEMENT PROTOCOLS.

ONE OF THE THINGS I'M MOST EXCITED THE COUNTY HAS REALLY DOUBLED DOWN ON IN THE LAST YEAR IS GETTING TO THE SOURCE OF THE PROBLEM AND TRAINING HUNDREDS OF CONTRACTORS WHO ARE CERTIFIED TO WORK ON LEAD ABATEMENT.

INCREASINGLY WE ARE NOT JUST DIAGNOSING THE PROBLEM WHICH IS ALSO IMPORTANT, BUT WARE TRYING TO GET TO THE SOURCE AND PREVENT CHILDREN FROM BEING EXPOSED IN THE FIRST PLACE.

>> SPEAKING OF ZIP CODE PROBLEMS, I UNDERSTAND THAT IN THE CITY, AND MAYBE IN THE COUNTY IN GENERAL, MOTHERS WHO HAVE NEW BABIES GIVE BIRTH TO BABIES WHO ARE AFRICAN-AMERICAN, ARE MUCH MORE LIKELY TO DIE THAN MOTHERS OF WHITE HIVE I'VE OR WHITE MOTHERS.

WHAT IS HAPPENING THERE?

>> SO THIS IS A TRENDS THAT HAS PERSIST TODAY FOR EFERL YEARS AND IT'S UNACCEPTABLE.

AND IT REPRESENTS A COMPLEX MIX OF MEDICAL COMORBIDITY THAT MAY BE MORE LIKELY TO PRESENT IN WOMEN OF COLOR AND THESE IMPACTS ARE SEEN IN THEIR INFANTS AS WELL WHERE THEY'RE DISPROPORTIONATELY LIKELY TO BE PRETERM AND SUFFER COMPLICATIONS OF PREGNANCY.

THIS IS A HUGE PRIORITY FOR US IN OUR AREA AS WELL AND IT'S A PARTICULARLY PERNICIOUS AND CHALLENGING ONE BUT SOMETHING WE ARE DEDICATED TO WORKING MORE ON.

>> AND I'M ASSUMING THE SAME THING IS FOR NUTRITION; THAT THE FREE LUNCH PROGRAM FOR KIDS IN SCHOOLS AND THROUGHOUT THE STATE, IS THAT GOING TO BE IMPACTED BY FEDERAL CUTS?

THE SNAP PROGRAM, THE WIC PROGRAM, WOMEN, INFANTS AND CHILDREN, IS THAT GOING TO BE IMPACTED?

>> WHERE NEW YORK IS HEADING IS HEADING TOWARDS FREE LUNCH AND BREAKFAST FOR KIDS IN SCHOOL REGARDLESS OF YOUR INCOME STATUS.

AND THAT'S A STATE INVESTMENT.

SO I THINK THAT'S REALLY IMPORTANT TO HAVE THAT OUT THERE.

RIGHT NOW WHEN YOU LOOK AT SOME OF THE WOMEN INFANTS AND CHILDREN PROGRAM, THE WIC PROGRAM.

WE RELY A LOT ON FEDERAL DOLLARS FOR THAT, JUST TO GIVE YOU AN EXAMPLE FOR THE STATE OF NEW YORK.

$578 MILLION IS THE FEDERAL INVESTMENT.

AROUND $26 MILLION FOR THE STATE INVESTMENT.

WHAT WE ARE SEEING IN NEW YORK, PARTICULARLY IS MORE PEOPLE NEED WOMEN INFANT AND CHILDREN PROGRAM, THE WIC PROGRAM BUT THE FEDERAL DOLLARS HAVE NOT KEPT UP WITH THAT.

IF YOU HAVE SEEN THE POPULATION NEED INCREASE A LOT BUT YOU HAVEN'T SEEN THE FEDERAL DOLLARS INCREASE SO THE STATE IS MAKING IT THE SHORTFALL, SO WE CAN TAKE CARE OF MORE PEOPLE.

I THINK THIS GETS TO A VERY IMPORTANT HEALTH EQUITY ISSUE.

RICH, NO ONE BENEFITS WHEN A CHILD IS HUNGRY.

NO ONE BENEFITS WHEN SOMEONE WHO IS PREGNANT IS HUNGRY.

AND WHEN WE TALK ABOUT HEALTH EQUITY AT THE NEW YORK STATE DEPARTMENT OF HEALTH.

WE ARE RECOGNIZING NOT EVERYONE HAS THE SAME STARTING POINT IN LIFE OR THE SAME ADVANTAGES YET EVERYONE DESERVES A FAIR AND JUST OPPORTUNITY FOR THE BEST HEALTH OUTCOMES.

WHEN YOU ACHIEVE HEALTH EQUITY, EVERYONE BENEFITS.

WE ALL BENEFIT WHEN KIDS ARE WELL NOURISHED.

THEY DO BETTER IN SCHOOL.

WE ALL BENEFIT WHEN MOTHERS ARE WELL NOURISHED, THEY WILL HAVE HEALTHIER BABIES.

WE ALL BENEFIT WHEN WE ACHIEVE HEALTH EQUITY.

NO ONE BENEFITS WHEN THERE IS POVERTY.

POVERTY IS ABOUT A LOT OF THINGS IT'S NOT ABOUT LAZINESS THOUGH.

IT'S ABOUT A LOT OF THINGS.

IT'S ABOUT ADVERSE SOCIAL DETERMINANTS OF HEALTH.

IT'S ABOUT LACK OF OPPORTUNITY, LACK OF EDUCATION, LACK OF JOBS, LACK OF OTHER CONNECTIONS BUT WHEN YOU LOOK AT POVERTY, IT'S VERY COMPLICATED.

>> SO IT'S SOCIAL DETERMINANT.

IT'S NOT JUST THE ONE PERSON.

IT'S ALL OF THESE FACTORS SURROUNDING THE PERSON.

>> YES.

IT'S-- I THINK YOU KNOW, THIS NOTION THAT PEOPLE NEED TO PULL THEMSELVES UP BY THEIR BOOTSTRAPS, IT'S MUCH MARREDDER WHEN YOU HAVE NO BOOTSTRAPS DO THAT.

>> THAT'S RIGHT.

>> AND I THINK THIS GETS TO THE LARGER ISSUES OF WHY IS IT SO IMPORTANT TO ME AS A STATE HEALTH COMMISSIONER THAT KIDS HAVE GOOD EDUCATION IN SCHOOLS AND WHY AM I GOOD FRIENDS WITH COMMISSIONER ROSA BECAUSE EDUCATION IS A POWERFUL SOCIAL DETERMINANT OF HEALTH.

WHY IS IT IMPORTANT TO ME THAT WE HAVE GREAT ROADS TO TRAVEL ON NEW YORK STATE AND I'M GOOD FRIENDS WITH COMMISSIONER DOMINGUEZ BECAUSE HAVE YOU TO GET AROUND THE STATE TO GET YOUR JOB DONE AND MOVE GOODS AND SERVICES.

IN OTHER WORDS, ALMOST EVERY STATE AGENCY HAS SOME ROLE IN ADVANCING THE PUBLIC'S HEALTH.

AND I THINK THIS REALLY, IT'S FUNNY.

I WAS TALKING TO THE GOVERNOR ABOUT HER OWN FAMILY HISTORY AND HER FAMILY CAME FROM IRELAND, SOUTH DAKOTA WAS THERE START MY FAMILY IS FROM IRELAND, TOO, BUT HER FAMILY CAME OVER TO SOUTH DAKOTA, MIGRANT FARMERS AND CAME AND WORKED IN THE STEEL FACTORIES.

THE GOVERNOR THOSE WHAT POVERTY FEELS LIKE AND LOOKS LIKE.

SHE DOES.

THAT'S WHY SHE IS FOCUSED ON LIFTING PEOPLE OUT OF POVERTY.

IF YOU LOOK AT THIS YEAR'S BUDGET, IT'S ALL ABOUT AFFORDABILITY.

HOW CAN WE MAKE LIVING IN NEW YORK MORE AFFORDABLE FOR EVERYONE BECAUSE YOU KNOW, THE REMEDY TO POVERTY ISN'T MAKING PEOPLE FEEL BAD.

THE REMEDY TO POVERTY IS MAKING LIFE MORE AFFORDABLE, HELPING PEOPLE SUCCEED.

THIS IS WHAT AMERICA WAS BUILT ON.

>> WELL, FOLKS, THIS HAS BEEN A GREAT CONVERSATION.

THANK YOU VERY MUCH.

WE ARE-- I THINK SOME OF WHAT YOU ARE TALKING ABOUT SEEMS JUST SO SELF-EVIDENT TO ME IT'S AMAZING THAT WE ARE GETTING RID OF THE SCIENTISTS WHO LIFTED US OUT OF THE DARK AGES AND BROUGHT ALL OF THESE OR THISSING TOES AND KNOWLEDGE TO-- ALL OF THIS INFORMATION AND KNOWLEDGE TO US TO MOVE THE WHOLE POPULATION FORWARD IN AN INTERDEPENDENT WAY WHICH I KNOW IS ONE OF YOUR KEY WORDS.

AND FOLKS, BEFORE WE WRAP OUR SHOW TODAY, I WANT TO INTRODUCE YOU TO MISS OLIVIA LANIAK, A MEDICAL STUDENT AT UPSTATE UNIVERSITY WHO WILL SHARE HOW TO SPOT THE SIGNS OF STREP THROAT, A DISEASE THAT BEFORE THE ADVENT OF PENCIL AN USED TO-- PENICILLIN USED TO KILL PEOPLE.

LET'S TAKE A LOOK.

>> HI, I'M OLIVIA LAINIAK IN THE NORTON COLLEGE OF MEDICAL.

MY MEDICAL STUDENT MINUTE IS ABOUT A COOL THING I'VE LEARNED.

HOW DO DOCTORS DECIDE WHETHER TO ORDER A STREP TEST AND ANTIBIOTICS.

IT'S ACTUALLY A SIMPLE FOUR STEP RULE AND DOESN'T NEED ANY FANCY EQUIPMENT THAT YOU DON'T HAVE AT HOME.

STEP ONE IS ASKING YOURSELF DO I HAVE A FEVER?

MOST COMMON COLDS THAT CAUSE SORE THROATS DON'T CAUSE A FEVER.

STREP DOES.

STEP 2: LOOKING FOR COMMON COLD SYMPTOMS.

THINGS LIKE A RUNNY OR STUFFY NOSE, COUGHING OR SNEEZING, USUALLY SIGNS OF A VIRAL ILLNESS THAT WILL GO AWAY ON ITS OWN.

STREP THROAT DOESN'T USUALLY CAUSE THESE SYMPTOMS.

THIRD IS SORE THESE WHEN YOU TOUCH ALONG THE SIDE OF YOUR NECK BETWEEN YOUR EARS AND SHOULDER.

THAT'S A SIGN THAT YOUR IMMUNE SYSTEM IS WORKING HARD TO GET YOU BETTER.

THIS CAN HAPPEN WITH A COMMON COLD, TOO, BUT THE PAIN IS USUALLY MUCH, MUCH WORSE WITH STREP.

LAST IS PATCHY WHITENESS AT THE BACK OF THE THROAT.

THIS CAN BE HARD TO SEE BUT YOUR PHONE FLASHLIGHT CAN ILLUMINATE THIS.

THESE WHITE PATCHES ARE ACTUALLY YOUR WHITE BLOOD CELLS FIGHTING OFF INFECTION.

PRETTY COOL THAT YOU CAN SEE THEM AT WORK WITHOUT SPECIAL EQUIPMENT.

IF YOU MEET THREE OR FOUR OF THESE CRITERIA, YOUR DOCTOR WILL PROBABLY WANT TO ORDER A STREP TEST.

PEOPLE IN PLACES LIKE SCHOOLS OR COMMUNITY CENTERS EXPOSED TO LOTS OF GERMS ARE MORE LIKELY TO GET STREP THAN THOSE WHO AREN'T.

IF YOU MEET ONE OR TWO CRITERIA, TRY DRINKING LOTS OF WARM FLUIDS.

IF YOU GET WORSE, OR DON'T GET BETTER IN A FEW DAYS, IT MAY BE TIME TO HEAD INTO THE OFFICE.

AND IF IN DOUBT, DON'T HESITATE TO SEE YOUR LOCAL HEALTH PROFESSIONAL.

SO IF YOU FIND YOURSELF THINKING DO I HAVE STREP THROAT, DON'T WORRY.

YOU NOW KNOW EXACTLY WHAT TO PAY ATTENTION TO.

FEVER, COLD SYMPTOMS LIKE COUGHING, SNEEZING OR RUNNY NOSE.

SORENESS ON THE SIDE OF THE NECK AND A PATCHY WHITE THROAT.

I'M OLIVIA LANIAK AND THIS IS MY MEDICAL STUDENT MINUTE.

THAT'S ALL THE TIME WE HAVE, I WANT TO THANK OUR GUESTS: DR. KATHRYN ANDERSON, HEALTH COMMISSIONER AT THE ONONDAGA COUNTY HEALTH DEPARTMENT; DR. BRITTANY KMUSH, ASSOCIATE PROFESSOR OF PUBLIC HEALTH AT SYRACUSE UNIVERSITY; AND DR. JAMES MCDONALD, HEALTH COMMISSIONER AT THE NEW YORK STATE DEPARTMENT OF HEALTH TO HEAR OUR COMPANION COMMUNITY FM RADIO SHOW, CHECK UP FROM THE NECK UP, VISIT WCNY.ORG/ COMMUNITYFM.

AND IF YOU WANT TO SEE THIS EPISODE AGAIN AND PAST SEASONS, VISIT WCNY DOT ORG SLASH CYCLEOFHEATH.

FOR CYCLE OF HEALTH, I'M PSYCHOLOGIST DR. RICH O'NEILL.

THANKS FOR WATCHING, AND WE'LL SEE YOU NEXT WEEK!

♪ ♪ ♪ ♪ NEXT WEEK ON "CYCLE OF HEALTH," Dr. RICH OWE NEIL AND COMPANY UNPACK THE GROWING BARRIERS TO HEALTHCARE ACCESS.

OUR TEAM ALSO VISITS A DENTAL SERVICES, DOWNTOWN DENTAL OFFICE IN SYRACUSE THAT PROVIDE SERVICES TO UNINSURED ADULTS IN NEED AND IN THE LATEST MEDICAL STUDENT MINUTE, DANIEL MAHONEY EXPLAINS HOW GENETIC TESTING COULD ONE DAY BE OFFERED AS A PREVENTATIVE HEALTHCARE SERVICE.