So what's the problem? What is the real issue in the US? And there are a lot of different issues. And we talked about one already, which is the ratio between social care spending and health care spending. But there are other pieces of that. We tend to focus our health care system on technology and on cure. And as we already mentioned, we do very little with respect to prevention or health promotion. These days, it's hard to even get things paid for that are clearly evidence based preventive interventions. We do pretty well with some forms of prevention, like early diagnosis and treatment, but we do not do well with primary prevention. And we'll talk about that later in the course. We also, as you know, have tremendous racial, ethnic and socioeconomic disparities in our country. There can be a discrepancy of as many as 15 years of life lost. If you live in one neighborhood, versus another neighborhood. These are in the same cities, same counties, same states in America. But if you are poor and live in certain neighborhoods, your chances of survival are reduced by 15 years. That is an outrage and something that needs to be addressed in our country. And it's very hard to figure out how to address that. If you're only thinking about the health care system, and not thinking about the broader community. We also have big issues with obesity. We still have issues with tobacco. As you know, we have issues with violence. Violence is becoming a leading cause of death and younger age groups. And the opioid epidemic has obviously done tremendous damage to our country. We now have seen a decrease in life expectancy due to the opioid epidemic. Really shocking thing to have happened. We again spend less than 2% for prevention. We talked about that before. And one of the things that I'm very interested in, is the way that we implement our scientific advances. And we talk a lot about translational science, which is really trying to figure out how to learn, how to move things from the laboratory into the clinical setting into public health. And that is an area where we don't do a very good job and there are many of us who are trying to work on that. How do we speed up that transition? How do we make those scientific advances applicable to many different communities? There is much work to be done in that area. And we will also be discussing that a little later in the course. My last summation, I guess of these various problems is that we tend to focus on health care for many people in this country. When you say the word health, they automatically think healthcare. They don't think about a broader construct of health, really. Health is what you do every morning when you get up in the morning. It is not when you go to your doctor. And so one of the things that we're trying to do across the country, and certainly in this lecture, is to get you to think very broadly about health. What does help mean to you? And how can we move our country towards better health? Because that's really the goal. So think health, not healthcare, that's really are critical message. And it requires thinking in a very different way about what the influences are on health. And we're going to talk about that also later in the course. But one of the things that I want to point out even before we go any farther, is the issue that we have in our system. Which is that, health care sort of stands separate from public health and research. And by public health, I'm including everything that happens outside the health care system that impacts health. So that might be community based organizations, that might be where you go to school, it might be what happens in your work site, It might be what happens in your church. And also, it is related to policies, whether they're at a local level, a state level or a federal level. So, the big bucket of public health is really very important, but is not connected to health care delivery in a very meaningful way. And similarly, as we discussed, research has been kind of a separate silo, not really addressing the most critical public health issues, not always addressing healthcare delivery. So, one of the things that we also hope that we will be able to share with you in this course, is this critical thing. This is the imperative, that we all get together. We all work together and we all think more broadly about health, not healthcare. So I hope that in this lecture we've covered the most basic issues around why there's a crisis in the US, with respect to health. We are not doing a good job and we are spending a lot of money on it. And we hope that, through the course of this program, we can suggest some different ways of thinking about things, and ways of working with our communities to improve health in the US [MUSIC]