SEGMENT 1: Orange County, California is home to nearly 3.2 million people. Its 42 miles of beachfront and major attractions such as Disneyland, Knott’s Berry Farm, and Mission San Juan Capistrano, make it a major West Coast tourist destination. Orange County is also home to the Children’s Hospital of Orange County (CHOC), where Dr. Sandip Godambe is the Chief Medical Officer. In a wide-ranging discussion, we talk with Dr. Godambe about the ways in which CHOC’s approach is similar to Nemours Children’s Health in going well beyond medicine.
SEGMENT 2: Childhood obesity is a serious problem in the United States, putting children and adolescents at risk for poor health. The prevalence of obesity for children and adolescents aged 2-19 pre-pandemic was 19.7%, affecting about 14.7 million kids. We’ll dive into this issue with Nemours Children’s Health Dr. Kirk Reichard — a leading national expert on childhood obesity and its treatments.
Guests:
Sandip Godambe, MD, Senior Vice President and Chief Medical Officer, Children’s Hospital of Orange County
Kirk W. Reichard, MD, Clinical Director, Division of General Surgery, Nemours Children’s Hospital, Delaware
Producer, Host: Carol Vassar
EPISODE 44 TRANSCRIPT
Carol Vassar, podcast host/producer:
Welcome to Well Beyond Medicine, the Nemours Children’s Health Podcast. Each week, we’ll explore anything and everything related to the 80% of child health impacts that occur outside the doctor’s office. I’m your host, Carol Vassar. And now that you’re here, let’s go.
Childhood obesity is a severe problem in the US, putting children and adolescents at risk for poor health. The prevalence of obesity for children and adolescents aged two to 19 pre-pandemic was 19.7%, about 14.7 million kids. We’ll dive into this issue with the Nemours Children’s Health Director of Bariatric Surgery, Dr. Kirk Reichard, a leading national expert on childhood obesity and its treatments later on.
First, though, let’s turn our attention westward toward Southern California. Orange County, California, is, by population, the sixth largest county in the US. Nearly 3.2 million people call the OC home, living and working in and around cities like Santa Ana, Irvine, Anaheim, and numerous peach towns along its 42 miles of oceanfront. Those beaches and numerous other attractions, including Disneyland, Knott’s Berry Farm, and Mission San Juan Capistrano, make Orange County a major tourist destination. OC is also the home to the Children’s Hospital of Orange County, or CHOC, where our first guest today, Dr. Sandip Godambe, is chief medical officer. CHOC consists of two hospitals, five centers of excellence, a robust population health program, and a framework that includes a pillar on equity that characterizes their mission as equity-driven. What is health equity in the pediatric space? Here’s Dr. Sandip Godambe.
Dr. Sandip Godambe, Chief Medical Officer, CHOC:
Equity is a very complex question. To me, equity is a combination of improving those outcomes so that everyone has access to healthcare, but more importantly also has the opportunity to be the healthiest that they can be. And that’s our job. I think we know, as healthcare providers, that we drive probably 10 to 15% of community health if you look at the literature. Now, as healthcare leaders, as healthcare systems and providers, we have to come up and understand the other 85% because we may take care of providers in our healthcare settings, but a lot more happens when they go home, when they’re in their schools, when they interact with their colleagues, their family members. And when you start understanding those drivers.
Carol Vassar, podcast host/producer:
Tell me more about the population you serve.
Dr. Sandip Godambe, Chief Medical Officer, CHOC:
Our population is very diverse, as you can imagine. We have a lot of Spanish speaking, and so as our health system delivery system, we have to basically take that into account. We have to understand, if anything, we have to master the social determinants of health to basically deliver our mission, which is to deliver equitable, safe, effective care. There’s a tremendous team. Michael Weiss, VP of Population Health, and many others are taking on that challenge. We also have a very strong primary care network, and of course, our subspecialty-delivered care that comes through our health system and, of course, our clinics. To me, the delivery of population health and its whole strategy to improve is dependent upon improvement science.
Carol Vassar, podcast host/producer:
Quick definition here of improvement science, courtesy of Brigita Skela-Savič and Kevin D. Rooney, and published in the Journal of the National Institute of Public Health in Slovenia. They came by this definition through work with clinicians and researchers from across Europe. Improvement science is, quote, “The generation of knowledge to cultivate change and deliver person-centered care that is safe, effective, efficient, equitable, and timely. It improves patient outcomes, health system performance, and population health.” This, of course, requires rigorous evidence-based data analysis and cooperation across the healthcare spectrum from clinicians, researchers, patients, families, healthcare systems, regulators, and payers. In other words, it’s complicated. Dr. Godambe.
Dr. Sandip Godambe, Chief Medical Officer, CHOC:
My background is fairly strong in improvement science, having been through the emergency medicine world. And I think what we understand is using those principles, especially things such as planned experimentation and factorial design is the future. If you look at the health systems that are doing population health well, they are basically implementing improvement science principles very well and, if not partnering very well through our communities, their schools, their teachers, and, of course, their families. And that’s our goal at CHOC. I think you met me at our booth, our wealth space where we actually have within our Irvine schools and others our leader, Mike Weiss, as well as Heather Huszti, our psychologist in chief, have put together, and of course, their respective teams, these spaces of respite within the schools where kids can go if they’re having a tough moment to just get a break. And those breaks actually deliver a lot of psychological relief, but if anything, give them a time to reflect and also gain control of their emotions where they can return to school. And it probably prevents a lot more mental unwellness than we think. And those are some of the studies we have ongoing.
Carol Vassar, podcast host/producer:
How many schools have the wellness space?
Dr. Sandip Godambe, Chief Medical Officer, CHOC:
I am going to take a guess, but it’s easily over 29 or 30. That number is growing every week to month.
Carol Vassar, podcast host/producer:
And you’ve looked at the research. Has it helped the mental health of children in these schools?
Dr. Sandip Godambe, Chief Medical Officer, CHOC:
It’s ongoing research. What we do have are the children get to scan in and tell how they’re feeling going in, and of course, using a Likert scale, how they’re feeling when they’re going out. And I think the number is just over 70% feel much better when they leave the respite space. I think the program is effective. And we’re fortunate to have some families and donors in the area that believe in the concept, so, of course, the idea is spreading to other school systems. And we’ve been asked to partner with some of the other schools that are further away from us as well.
Carol Vassar, podcast host/producer:
Talk about the importance of collaboration, of partnership in addressing the issues, 80% or 85% of which happen outside the doctor’s office but do impact a child’s health.
Dr. Sandip Godambe, Chief Medical Officer, CHOC:
Yeah, I think I’ll start by saying that when we deal with trainees, I always remind them that at some point in life, we’ll not only be providers of healthcare, but we’ll be consumers of healthcare. And we keep that perspective in mind. We started understanding that we want to co-design and co-implement our healthcare with our families. And, of course, being a parent myself, my wife and I we have three kids, so we naturally want the best for them. And we should expect nothing but that the families that we take care of want that for their children. Naturally, we will partner with our families, and we are. We’re no different than Nemours. I know Nemours does a very good job at partnering with their families, having known a lot of your leaders.
Carol Vassar, podcast host/producer:
What about partnerships between yourself and the community, a healthcare system, and the community? Be it the schools, be it the nonprofits in the community. How does that help the health of a child?
Dr. Sandip Godambe, Chief Medical Officer, CHOC:
Yeah, I think that’s the challenge. That’s that other 85% we’ve talked about. Yeah, we are partnering with our schools. We also have to partner with our pharmacists, all of those. We need to know who fills their prescriptions. We need to know who doesn’t. And start understanding those parts that make our families, and our children in particular, better and healthier. Yeah, I think it’s an ongoing learning experience. I would even say even our religious organizations, they are all part of the equation.
We have to follow a day of a child, and a great example is our mental health program. I think if a child that presents to the emergency department that we’ve missed many opportunities, and so it’s our job or it’s our opportunity to make this better. And that does take partnership. And every child has a different day. We know things such as food security home security, that ultimately all affect mental health. And so those are the complex equations we have to understand.
I think if we look at it from a randomized controlled trial study perspective, we don’t have 17 years to deliver the improvement. And that’s where I think improvement science principles, done in appropriate fashion, can deliver the changes we want in one to two years. And that’s our goal at CHOC and, I’m sure, at other health systems like Nemours. These are complex questions you’re asking. They affect our kids, so it’s important.
Carol Vassar, podcast host/producer:
Now, you mentioned emergency medicine. You spent 25 years, nearly 25 years as an emergency medicine physician. You were on the front lines. You saw how the social determinants of health impacted a child’s life. Tell us about your work in the ED and what you saw in terms of SDOH that we can improve.
Dr. Sandip Godambe, Chief Medical Officer, CHOC:
Yeah, I think, fortunately, I’ve had the opportunity to work at five different health systems with pediatric emergency medicine, and all had their respective challenges. There isn’t a day that goes by in the life of a frontline provider in the emergency department that you don’t… You wish for better. And you know that children present with the circumstances that they do. And there are opportunities. We know that outcomes differ depending on where you live, what your family life is like, what your family’s education is. And that’s our opportunity to make a difference as health systems. The emergency departments can only do so much. It takes partnering with them and understanding all of these factors. But it will take an investment not only in dollars but, more importantly, in training our future providers to understand just that. And that’s where our research needs to go. I think we have opportunities. I think everyone comes to work wanting to do a great job, so we need to provide them with the tools and the abilities to make a difference.
Carol Vassar, podcast host/producer:
I’m handing you a magic wand right now. You can change one thing in pediatric health. You have all the resources in the world, all the money in the world. What would you change?
Dr. Sandip Godambe, Chief Medical Officer, CHOC:
How to improve access. I think their pediatric hospitals are the place where a lot of good things happen, but sometimes they’re not very accessible because we’re not everywhere. And so it’s our opportunity, as pediatric health systems, to be out there, to reach out, and similarly, to be open for various ways of delivering healthcare where telehealth, in-person, mobile vans. We are trying all of these in California. And I think these are our opportunities. And we have to learn from them.
I’ve also learned a great example is we may have clinics in different areas. Each family or type of patient goes to those areas may have different needs, and we have to understand how to customize our healthcare to different customs, different ethnicities, and deliver that proper service. And that’s when we’re going to succeed. But it takes time, it takes patience, it takes people who are passionate, which I think occurs at health systems, pediatric health systems in particular, but it’s that opportunity. I’m a glass-is-half-full kind of guy. I think my wife has taught me that. And I think we need to look at this as a huge opportunity moving forward.
Carol Vassar, podcast host/producer:
I want to go back to your days in the emergency department. Is there a patient whose story stays with you and inspires you as you move forward in this work? Which is complicated work to be done in healthcare.
Dr. Sandip Godambe, Chief Medical Officer, CHOC:
Yeah. I think we forget that kids can’t seek healthcare on their own. They are where they are. In my career, probably more so when I was practicing in the Midwest, we’d have kids who were victims of gun violence. And I think those are opportunities for us to understand why. And those solutions aren’t just healthcare-based based they’re looking at, and as you stated earlier, is who we can collaborate with, our religious partners, our schools to make this event no longer happen. And that’s our opportunity. And I look forward to those who are working on this across the country. But it’s more than just healthcare, as I alluded to. That’s an opportunity.
Maybe a patient other than a gun violence patient that I can probably bring up is a child who is left alone, and because of the single parent who’s working hard, can’t get the care they need. And that gets into the access. Do we have access points at night when that single parent isn’t able to seek care for their child that’s not just an emergency department? Those are the ways we need to think. Is it that we connect through their cell phones? Is it the opportunity for telehealth? I don’t know the answer, but I know there’s a lot of health systems like ours that are trying to tackle this. And I think these are opportunities moving forward in connecting the dots.
Carol Vassar, podcast host/producer:
Can tech and innovation help?
Dr. Sandip Godambe, Chief Medical Officer, CHOC:
Absolutely. I think AI can help, but it’s the overused word. And we need to make sure that it has to be done properly, thoughtfully. We also have to build up our databases so we can do this right. It may… It will, not may, will require hospitals to partner with each other.
Carol Vassar, podcast host/producer:
And without bias because algorithms can have bias.
Dr. Sandip Godambe, Chief Medical Officer, CHOC:
Without bias. Absolutely.
Carol Vassar, podcast host/producer:
I want to ask you a personal question. I understand you’re a musician. And is that something you do as a form of self-care? And how important is self-care in your field?
Dr. Sandip Godambe, Chief Medical Officer, CHOC:
I’m careful how I answer that because I know my kids may someday listen to this. I am fortunate to be married to someone who is very musically talented. I do play the violin. My kids all play, and so they’re much better than I am now. I think having releases, whether it’s sports, running, or music, is important. It’s our opportunity to think, ponder about our day, our lives, but more importantly, also to express ourselves creativity. And I think our creativity is what helps drive our careers too. And I think it’s a combination of being the whole person. Sometimes we can get bogged down. And our day-to-day lives are busy, especially coming out of a pandemic. And we just need to be mindful about self-care because that’s how we’re going to address some of the issues that we call burnout. But it will require a whole system effort.
Carol Vassar, podcast host/producer:
Do you worry about the physicians who work for you? 1,300 of them.
Dr. Sandip Godambe, Chief Medical Officer, CHOC:
Every day. And all of those providers are at risk. And we know it is a worldwide problem, having been part of some of the global work on this. And at CHOC, we are addressing it, but it’s going to take engagement from everybody.
Carol Vassar, podcast host/producer:
How are you addressing it?
Dr. Sandip Godambe, Chief Medical Officer, CHOC:
Well, we have a joint work effort. We actually collaborated initially with the global network out of the Institute for Healthcare Improvement in Boston. And we were part of 17 other hospitals globally. We started meeting in 2021. And it’s been ongoing. It’s hard work because people sometimes think giving donuts or things like that is what delivers joy.
Carol Vassar, podcast host/producer:
Pizza.
Dr. Sandip Godambe, Chief Medical Officer, CHOC:
And it’s more than that. It’s letting people come to work and be creative. And that’s where I think the role of wanting to make a difference where you work, using improvement science or whatnot, is how we are going to deliver it, where it’s not just about the clinical work, but it’s the opportunity to improve your day-to-day, to be an active participant in that. And that’s going to help drive burnout down when we feel like, hey, we’re engaged more than just our day-to-day patient care, but there’s opportunities to make a difference for all of us.
Carol Vassar, podcast host/producer:
Dr. Sandip Godambe is the chief medical officer for the Children’s Hospital of Orange County, CHOC, based in Orange, California. Pediatric surgeon Dr. Kirk Reichard has been immersed in childhood obesity prevention and treatment at Nemours Children’s Health for more than 20 years. He serves as Nemours’ Clinical Director for the division of general surgery, OR surgical director, and director of the Nemours Bariatric Surgery Program. It’s an area that he identified early in his career as being of growing concern and one where he knew he could have a profoundly positive impact. Here’s Dr. Kirk Reichard.
Dr. Kirk Reichard, Nemours Children’s Health:
It became pretty clear to me, even during my training, that the obesity problem was getting much worse in children. We were seeing it every day. We were seeing the results of obesity, diseases that we used to only see in adults. Right around the time that I joined Nemours, conversations about metabolic and bariatric surgery in children began to occur very much on the sidelines. And so myself and about six or eight ped surgery colleagues throughout the country have really been pushing that conversation. I chaired the Pediatric Committee of the American Metabolic and Bariatric Surgical Association for about six years, and during that time is when we wrote a lot of policy statements and guidelines and really moved that conversation front and center that obesity in children was a serious problem, it was getting worse and it caused a lot of chronic disease and we really needed to do everything we could do to get control of it.
Carol Vassar, podcast host/producer:
Give us some context on how, for lack of a better word, how bad the situation is right now with obesity in children in the US.
Dr. Kirk Reichard, Nemours Children’s Health:
Well, the latest data we have is from the CDC, the NHANES database, which, last collected, actually in 2019. And at that time, 20% of all children in the country were obese, which is defined as greater than the 95th percentile for people their age and gender. We suspect that it’s gotten far worse during the pandemic, and we’ll probably get some data later this year and next year. But the pandemic really laid bare all of the social inequities that we know are already underpinning obesity, so we expect a fairly dramatic increase even from there. Children with that level of obesity have diabetes, they have high blood pressure, they have sleep apnea, they have abnormal lipids and triglycerides that lead to cardiovascular disease later in life. They have liver disease. This is not an isolated problem, and the longer we wait to take care of it, even at a very young age, the harder it is to get those associated conditions to go away.
Carol Vassar, podcast host/producer:
I want to ask, what are the causes?
Dr. Kirk Reichard, Nemours Children’s Health:
We believe it’s partly genetics-based. It’s partly metabolic-based. Different human beings have different set points for their weight, and we’re beginning to understand some of the biology behind that. And it’s not really just a failure in personal accountability, which is what people used to think. It is just like your hair color and your eye color. Some people have a tendency to keep calories and make fat. Other people have a tendency to burn calories. And that’s just the way it is. Some of the most recent treatments, including some of the new medications in certainly metabolic and bariatric surgery, are designed to attack those biological problems. And we’re just really beginning to scratch the surface in our understanding of it. But that’s why we call it metabolic and bariatric surgery because it really isn’t about losing weight. It’s about dealing with the metabolic consequences of obesity and trying to help kids lead a healthy life. That’s what we’re doing here at Nemours.
Carol Vassar, podcast host/producer:
Some people would say, “Bariatric surgery for a child? That sounds very extreme.” But it’s something that happens. Talk about that. At what stage in a child’s life does it come to the point where bariatric surgery comes into play?
Dr. Kirk Reichard, Nemours Children’s Health:
It’s a combination of their level of obesity, which, again, we calculate based on CDC curves that all pediatricians have. If a child is more than 20% heavier than the 95th percentile of weight, which is confusing, but that’s what we use right now, they have a level of obesity that will almost certainly lead to all of these other serious diseases. There is no justification at that point not to proceed with offering everything we have available to children.
We start with very intensive lifestyle therapy and behavioral therapy. We teach them about nutrition. We teach them about exercise. We have really great people from all those fields on our team. And then if they get to the level where they’re at this class two obesity, some of the newer medications are indicated. Although they’re not FDA-approved yet for children with purely obesity, there are a lot of clinical trials going on, and I expect that’s going to change. And then metabolic and bariatric surgery is now considered a very reasonable alternative. And in fact, the AAP recommends that all children with obesity are referred to a center like ours that can do all of the things, including medications and surgery.
Carol Vassar, podcast host/producer:
What are we seeing happening from a public health perspective to reduce the rate of obesity in children in the US?
Dr. Kirk Reichard, Nemours Children’s Health:
I think there are a lot of things going on. There’s no question that obesity is a disease of social inequity. I just presented a paper where I showed that children with low childhood opportunity indexes in our state, in our primary care offices-
Carol Vassar, podcast host/producer:
Which is Delaware.
Dr. Kirk Reichard, Nemours Children’s Health:
… which is Delaware, are almost twice as likely to have obesity as the children from high opportunity index neighborhoods. And we’ve got it mapped out now. We know where they are. One of them happens to be about eight miles from our hospital, one happens to be about 10 miles from the food bank, so there are a lot of opportunities for us to begin to target.
More on the federal level, the Women’s Infants and Children Nutrition Program has been extremely effective. It’s continued to be funded. And in families and children who participate in WIC, the obesity rate is clearly lower. It’s very difficult to apply for WIC. And most children, by the time they’re two, have dropped out. That’s one area that we can be a lot more proactive and help our families apply for that benefit. Because the money’s there in Delaware, it’s just not being used.
The SNAP program, which people call food stamps, is another really nice lever. I was here earlier in the summer with the Nemours National Office lobbying for the food bill, which has not yet been reauthorized, and I don’t know when it’s going to be, but that is very clearly… And there’s lots of data to show that that is a help in terms of not only food insecurity but obesity rate. And then the most recent one was actually an Obama era legislation called the Healthy Hunger-Free Kids Act, which basically supplements school lunch programs on non-school days, including weekends and holidays. Just very recently, they’ve published their first findings that children who participated in that… And they knew who they were. They had their weights going on. They actually lost weight while they participated in that program. Clearly targeted efforts to deal with, in particular, food insecurity, but early literacy is important. We’re doing a lot of work with our food bank in Delaware to supplement the School Bag Lunch Program that they have with some age-appropriate books to help them learn about fruits and vegetables and healthy eating.
I think it’s a multi-pronged effort. We have a long way to go, but there’s a lot of interest in it now. Just at this academy this week, three or four of us have presented papers on this. And it’s definitely front and center for the federal government right now.
Carol Vassar, podcast host/producer:
I want to hear more about the paper that you presented. Tell us.
Dr. Kirk Reichard, Nemours Children’s Health:
I collaborated with the VBSO, our Value-Based Service Organization. And actually, my son, who was an intern there last summer, wrote an app that allows us to look at our patients with, let’s say, obesity that are seen in our offices. And we do ask our families about food insecurity. We asked them if, in the last six months they were concerned that they didn’t have enough money to buy food. And if they answer yes, then they’re considered food insecure. We were able to look in the past year at all of our primary care and especially outpatient visits. I think there are close to 50,000 kids. We had their BMIs, and we had their answers to the food insecurity question. And then, with the app that was developed with my son’s help, we were able to map those patients to neighborhoods that had particularly low scores in the Child Opportunity Index.
And the Child Opportunity Index is a very well-vetted national measurement. There are 29 different dimensions. Food insecurity is only one of them, but it’s education, it’s the environment, it’s neighborhoods, it’s education. It really is a much more comprehensive way to deal with or to measure inequities of every kind. And so, using census data, we’re actually able to map our patients in neighborhoods where the COI scores are particularly low. And again, in those neighborhoods with low COI and families that live there, the obesity rate was nearly twice. And with very low COI, the obesity rate was actually 2.3 times what it was in neighborhoods with children with high Opportunity Index.
It was really quite powerful. We were able to produce a map of Delaware and really pinpoint those census tracks. And those are basically neighborhoods, so we know exactly where our kids live. And again, we propose that it will give a way for us to start targeting interventions and know, based on their future primary care visits, whether we’re making an impact or not.
Carol Vassar, podcast host/producer:
I’ve heard you say the word or the phrase food insecurity many times in our discussion. We’re also talking about obesity. What’s the connection between the two?
Dr. Kirk Reichard, Nemours Children’s Health:
There is a very close connection between food insecurity and obesity. People don’t think of it that way, but food insecurity really it just means that families don’t have the resources to purchase nutritious food consistently. Most of our families that are food insecure are not starving. The children are not losing weight. On the contrary, they tend to have obesity because calorie-dense foods are much cheaper and they taste better. Let’s face it. A mom who’s holding down two jobs and is a single mom and has three kids, she’s not going to go to the grocery store and buy broccoli because she doesn’t know if her kids will eat them. That’s what we mean by food insecurity.
Many of these neighborhoods, while they do have food stores available, they tend to be the neighborhood bodegas that really have no fresh food. They don’t have fruits and vegetables. They don’t have lean proteins. I’ve heard some people say that when a Wawa moves into a neighborhood, it’s a sign that things are improving because they do have those things. You can get fresh fruits and vegetables at a Wawa, for example. Children who live in neighborhoods with high pollution and excess heat that add to the obesity rate. When they can’t go outside and play, maybe their neighborhood isn’t safe enough to go outside and play, maybe they go to a school that doesn’t have physical education classes or doesn’t have organized sports. Those are all different things that really feed into this problem, which is multifactorial.
Carol Vassar, podcast host/producer:
Now that we know in Delaware where these kids are, what’s the next step?
Dr. Kirk Reichard, Nemours Children’s Health:
I would like to get some funding from the USDA. I’ve actually been in conversations with the CDC as well. They have some funding and try to design some programs maybe with the food bank, maybe with Nemours, to really get food and nutritional education into these areas that we know these families are. For whatever reason, they have a hard time accessing the food bank, they have a hard time getting to stores that have healthier food, so we need to get into their neighborhoods. And I think we have the resources to do that. Dr. Moss talks about 80% of what goes into the health of a neighborhood has nothing to do with what we do in our four walls. It has everything to do with addressing these issues that I’ve been talking about before they cause disease.
Dr. Kirk Reichard, Nemours Children’s Health:
Are we turning the tide at all with regard to obesity?
Dr. Kirk Reichard, Nemours Children’s Health:
There is some early evidence in the very youngest children, those under five, probably because of WIC, that actually the rate looks like it’s leveling off. We’re waiting to see what happens after the pandemic. But probably in the last six or eight years, it looks like at least in that age group, we’ve seen a leveling off. I would like to think that we can do better than that with school-aged children. And I would like to think that we can increase funding for all of these safety net programs, if you will. It’s going to be a lot of work.
Carol Vassar, podcast host/producer:
Are there partners who are not at the table that you’d like to see at the table?
Dr. Kirk Reichard, Nemours Children’s Health:
I think there are a lot of community-based organizations that are already ready and willing to do this. I mentioned the Food Bank several times, but there are other organizations that we’re working with; some of them are Faith-based. Some of them are government organizations. I think private-public partnerships, in general, working with the YMCA to get resources for more kids to get more physical activity. The Delaware chapter of the AAP is now a reach-out-and-read chapter, a formal one. And we’re taking that opportunity to work on nutrition education and age appropriate books and dental health and mental health. I think there are so many ways we can do this, and I think we just need to be creative and reach our arms out to some of these community-based programs. And they’re willing to help. Some of them really are starved from resources. We can help with that. Some of them just don’t know where the needs are most. We can help with that.
Carol Vassar, podcast host/producer:
Dr. Kirk Reichard is the director of the Nemours Bariatric Surgery Program. Many thanks to today’s guests, Dr. Sandip Godambe and Dr. Kirk Reichard, for spending time with us while attending the American Academy of Pediatrics 2023 meeting in Washington, DC. That’s where they boarded the Nemours Children’s Health Podcast truck to record these interviews.
2024 is nearly here, and we’d love to hear from you about ideas and topics For upcoming podcast episodes. Leave us a voicemail with your thoughts at nemourswellbeyond.org. That’s nemourswellbeyond.org. That’s also the place where you will find previous podcast episodes. You may also subscribe to the podcast there and leave a review.
This week, our production team includes Che Parker, Susan Masucci, and Cheryl Munn. Join us next time as we delve into the topic of culinary medicine. I’m Carol Vassar. Until next time, remember, we can change children’s health for good well beyond medicine.
