Public health needs to find its way through “the in-between”

Finding ways to navigate what one speaker called the “in-between” was a dominant theme of the public health track at this year’s Yale Innovation Summit. The summit, held May 28-29 at the Yale School of Management (SOM), featured a number of Yale School of Public Health (YSPH) experts discussing a future with radically different funding and priorities.

Health track organizer Kaakpema “KP” Yelpaala, MPH ’06, a YSPH senior fellow and lecturer said key themes of the summit were to “highlight how innovation supports population health, and to connect the dots between health innovation and people’s day-to-day lives.” This year’s summit drew 2,360 investors and leaders working in health, the arts, biotech, climate, technology, and civic engagement. For the health track, some of its sessions had people lining the walls, and sitting in the aisles and overflow rooms.

Many of them may have come looking for clarity about federal health policy and funding. The uncertainty prompted YSPH Dean Megan L. Ranney, MD, MPH to reference “the in-between moment we’re in” during a fireside chat with former HHS Secretary Alex M. Azar, JD ’91.

“It’s important to acknowledge uncertainty,” Azar said, noting that the United States is undergoing one of the biggest political party realignments in its history. Driving this shift, he said, is a sense that “anything big is not trusted.” He thinks there is room for change, including “peeling back the mission creep of the CDC.” Noting that “change is not always a bad thing,” he said he sees opportunity for U.S. health agencies to emerge on the other side nimbler and more effective.

Azar also mentioned the critical need to move from a fee-for-service health care financing model to value-based care to better align financial incentives with health outcomes. This has been happening over several administrations, and he believes efforts towards value-based care models should be accelerated.

Ranney said dismantling the public health infrastructure before there’s a new plan is challenging for academic institutions who are training the next generation of public health leaders, as well as entrepreneurs thinking about how to structure their companies.

“If you want to come up with a new way to screen for lead poisoning, that would be good. But now we’re seeing kids not getting screened at all,” she said.

Azar advised entrepreneurs to focus on their work and how people will benefit from it—to keep their heads down and do the science.

Recent cuts to federal funding that has supported public health programs preoccupied many speakers. A hold on federal immunization funds came up in a panel addressing national and state public health programs. If the hold continues, state and local officials have to create new plans for how to respond to potential disease outbreaks. “Can we operate in an environment where we don’t have that funding?” said Dr. Manisha Juthani, MD, commissioner of the Connecticut Department of Public Health and adjunct professor at Yale. “We can, but it would be operating on a shoestring budget.”

Speaking on the same panel, Dr. Anne Zink, MD, a YSPH senior fellow and lecturer and former chief medical officer for Alaska, focused on the potential to make data accessible and actionable. Democratizing data will let people “Innovate from your expertise to improve the issues you see that need to be solved,” Zink said.

Making the data that drives decisions more transparent will also help restore trust in public health, she said. “Health is deeply personal, and people want to make decisions for themselves and their communities.”

The difference between statewide and local lenses on data was a theme of a separate talk by Mark Abraham, MPH ’23. Abraham is executive director of DataHaven, a New Haven nonprofit that collects and ensures access to data on well-being, equity, and quality of life. Abraham discussed two academic studies about longevity, including a groundbreaking report by YSPH, to show the link between place and policy innovation.

“It's not just the policies of your state that matter, but whether the benefits of those laws reach every single family,” Abraham said. He noted that while Connecticut residents have better-than-average access to dental care and live in a state that limits access to tobacco, “the community-level data show that not everyone gets the same mileage from those,” Abraham said. “We need to have the courage to break down the data, to see who benefits and who doesn’t.”

A session on global health looked at the grim situation for global aid. According to Jo-Angeline Kalambo, MPH ’03, a senior specialist at The Global Fund cuts to its funding will affect its ability to fight infectious diseases. The Global Fund is responding by emphasizing why funding is so important to the health of global communities.

New ideas and techniques could help address some issues in global health. Artificial intelligence (AI) including machine learning could help address the shortage of physicians, nurses, and other health care professionals, said YSPH Adjunct Professor Mehul Mehta. Technology-enhanced systems, including AI applications, could extend access to care and level the playing field in terms of health outcomes for low-income populations globally.

Karina Rios Michel, chief creative and technology officer at Girl Effect, gave specific examples of how her organization is developing and using multi-lingual chatbots built on large language models (LLMs) to improve access to important health information for young girls and adolescents in India, Kenya, and South Africa. Yelpaala is collaborating with Michel and her team on a YSPH case study on Girl Effect’s model for the responsible development of multi-lingual LLMs in global health.

American colleges and universities are facing declining trust in higher education and significant threats to funding, said Yale University President Maurie McInnis. But university research is essential to public health. Yale’s pioneering role in the discovery of penicillin, McInnis said, “revealed to the American public a profound truth about universities, that what happens in labs can help people around communities.”

She added, “Here at Yale, innovation is woven into our DNA.”

The summit’s annual pitch competition awarded more than $350,000 in funding and prizes. Third place in the health track went to Upkeep Care, co-founded by Blake Robertson, MPH ’24 (health care management). Upkeep Care provides an artificial intelligence platform that connects older adults and caregivers to resources, and won the YSPH Thorne Prize for Social Innovation in Health or Education in 2024.

Snippets from sessions at the Yale Innovation Summit

• “If you eat at a restaurant and you don’t get sick, that’s a public health accomplishment.” Dr. Manisha Juthani, MD, commissioner of the Connecticut Department of Public Health and adjunct professor at Yale.
• “The person who is thinking about community health, rather than individual health, is a public health practitioner.” Dr. Anne Zink, MD, a YSPH senior fellow and lecturer and former chief medical officer for Alaska.
• When former HHS Secretary Alex Azar said he doesn’t believe Congress will approve the proposed 40% cut to the National Institutes of Health (NIH), YSPH Dean Megan L. Ranney reacted with “from your mouth to God’s ears.”
• Dr. Jarred A. Bressner, MD, an orthopedic surgeon and principal of Activate Venture Partners, asked his panel “How can we bring people back to trusting the medical community to keep us healthy?"

One answer was “When you talk about how to create trust in community, a very simple solution is making sure you are supporting entrepreneurs who are born of the patients you are serving,” said Diego Mariscal, founder, CEO and Chief Disabled Person at 2Gether-International, a startup accelerator for disabled founders.

Dr. Alexi Nazem, MD, general partner at the investment firm AlleyCorp, said focus on health, not health care, noting a study showing that healthy behavior improved health and longevity in veterans. “How can we peanut-butter spread these best practices across populations instead of developing a new pill?” he asked. “It might be the way to go.”