Health Update: Wellness Wednesday: Mental health, food labels, AI and health care – What Experts Say

S1: It’s time for KPBS Midday Edition on today’s show. Mental health in the face of Ice detentions and deportations. Plus how to spot misleading food labels , then how AI is transforming health care. I’m Jade Hindman with conversations that keep you informed , inspired , and make you think. The American Psychological Association says the mental health impacts of current immigration enforcement are vast. A local psychologist explains , plus , a new lawsuit into a popular Costco item is bringing attention to misleading food labeling practices. We’ll talk about that. Then we’ll talk about the ways AI is being used for medical advice and health care. That’s ahead on Midday Edition. The psychological impacts of President Donald Trump’s mass deportation campaign are far and wide. Providers point to the mental toll of detentions , deportations and fearing for the safety of loved ones. There’s also the constant barrage of videos and photos of federal agents detaining neighbors and people we see every day , and that trauma and chronic stress compound the existing social challenges already faced by many immigrants , according to the American Psychological Association. Joining me to talk about this is Mariela Shibley. She’s a clinical psychologist and founder of the nonprofit Immigration Psychology Partnerships. Mariela , welcome to Midday Edition.

S2: Thank you. And thank you so much for inviting me.

S1: Well , I’m glad you’re here for this important conversation because you work very closely with immigrant communities here in San Diego.

S2: So there’s always been fear among undocumented individuals and their families. That’s that’s not new. But before , for many families , it felt like a possibility in the background. And now it feels much more real. It feels more immediate , more personal. Everybody knows someone whose loved one was detained. Everybody’s heard of a story of someone being picked up at an appointment or doing what was supposed to be a routine process. So the fear is no longer abstract. It’s just it’s concrete. It’s no longer that could happen. It’s this is happening. And so what I’m seeing clinically is chronic stress. People are having difficulty sleeping , concentrating , functioning at work. There’s this Pervasive anticipatory anxiety. Almost like they’re just bracing themselves all the time. They’re in this like fight or flight mode all the time. So even individuals who have strong legal cases and excellent attorneys , they no longer feel so reassured. You know , in the past , if you had everything in order , you could feel , you know , cautiously optimistic. But now , even with all the evidence in a very solid case , there’s still a high probability that things may not turn out okay. Yeah.

S1: Yeah. Well , I understand that you also do psychological evaluations in immigration court.

S2: What’s changed really is just the emotional tone of the evaluation. So in the past , when families were still together and had a strong case , um , one of the things that I have to evaluate. So for example , in a case of a deportation. Right. So if a family member is in removal proceedings , um , I would be evaluating their loved one , their US citizen or lawful permanent resident , spouse or parent or child and um , and what they need to prove is that if their loved one were to be deported , they would suffer exceptional and extremely unusual hardship. It’s a legal term for it. And so in the past , what I would see was that because they’re still together and they have a good attorney and they have a pretty good case , it was sometimes difficult for them to even imagine deportation happening. Um , you know , there was some degree of fear , but there was also hope. They felt very reassured. But now , even when everything’s done correctly and they have an excellent attorney and they have a solid case , there’s still a very real possibility of detention or deportation. There are no guarantees. And that uncertainty just really affects the individuals that I , that I work with. It’s just no longer a hypothetical hardship. It just feels a lot more imminent these.

S1: Days , and there are so many people in that situation. I mean , more than 4 million U.S. citizen children live with at least one undocumented parent.

S2: Um , you know , what I see is that parents with their best intentions , they try to shield their children. So they say , oh , everything’s going to be fine. You have nothing to worry about. But at the same time , they have the TV on at home. Right ? And children see social media and they see videos of children crying while their parents are being detained. So they’re they’re receiving conflicting messages every day. On the one hand , you’re safe. But also we’ll look at what’s happening. And that inconsistency creates a lot of anxiety. So what I’m seeing is so we all understand what post-traumatic stress is , right ? That’s after something terrible happens. But what I’m seeing now is what I call pre traumatic stress. These children , perhaps they haven’t personally experienced attention yet , but they’re living in anticipation of it. And that anticipation can be just as immobilizing um , as , as the post trauma. And this is showing up in their academic performance in irritability , withdrawal anxiety symptoms because children need predictability to feel safe. And and right now that predictability just feels so fragile.

S1: And if you can , you know , take me into the mind of a young child. Um , how confusing and disorienting is this for young children who just do not understand what’s going on , right ? Right.

S2: Because young children are they’re especially vulnerable because of how they think developmentally. So they have a tendency to see the world very concretely in black and white. Good or bad , right or wrong. So when they see a parent detained , they don’t. They don’t understand immigration law. So so they think if my daddy didn’t hurt anyone , why is he being arrested ? So it disrupts their sense of justice. And it’s also really challenging because parenting , they see they see their parents as their protectors. They’re they’re they’re superheroes. And seeing that protector powerless is profoundly disorienting. It shakes their sense of safety and even their identity. And and children , especially the younger children , are very egocentric in their thinking. They think they think that everything’s about them and that events happen because of them. So they might secretly believe that , you know , maybe it happened because I didn’t do my homework or because I was mean to the cat. It just. It sounds irrational to us , but it’s very real to them. And if that belief isn’t addressed and processed , they carry it. Not perhaps not consciously , every day , but somewhere deep inside. And it chafes their sense of safety in the world and their worldview. Yeah.

S1: Yeah. Well , I also want to talk about the link between generational trauma and then immigration enforcement added on to that.

S2: I was born in Argentina during a period of military dictatorship , and I was very , very young. And no one really explained to me what was happening. But I remember sensing the fear , especially fear of authority figures. So even though that period , of course , ended , those emotional imprints remain. And now myself watching what’s happening. I can feel those old memories being stirred. And so this is to show that children absorb emotional climates even when no one explains it to them. So in trauma doesn’t just disappear just because we don’t we don’t talk about it. It it embeds itself in someone’s psyche and in our family systems. So when children don’t have a space to process what’s happening , then they create their own explanations. And as I said , those explanations tend to be egocentric and self punitive. So if those narratives aren’t corrected , they carry that weight into adulthood. So we’re going to see the repercussions of this for decades. Hmm.

S1: Hmm. Uh , you know , I want to broaden this conversation a little bit because all of this is happening while folks are trying to process a wave of racist rhetoric coming from the white House , too. We recently saw President Trump post an image depicting President Barack Obama and former First Lady Michelle Obama as apes. He spewed racist ideas about Haitian immigrants. Um , said that people , black and brown people coming into the country come from asshole countries. Um , these are all ideas that are forming into policy , right ? So talk to me about what racism does to the psyche and how it impacts health.

S2: You know what what I think concerns me most about the racist rhetoric coming , especially coming from leadership , is that it normalizes something that should never be normalized. So when dehumanizing language becomes public and visible , it it like it gives a green light. It lowers societal boundaries. So for people , you know , people who have strong moral convictions , who have a strong sense of conscience. It may not change their behavior so much , but for individuals who have a lower conscience , a weaker internal boundaries , that kind of rhetoric can be sort of the nudge that they need. Um , it it legitimizes hatred. And so that’s on the side of , of the , um , you know , the people that are spewing this , this message , but also for the people being targeted , it reinforces shame and fear and the sense of not being wanted. So , you know , this language just really , really matters. And and when the rhetoric shifts , then , um , unfortunately , behavior sometimes often follows. So it bleeds that way as well.

S1: You know , as a therapist working with people directly impacted by these policies , what are you saying to your clients right now ? Where do you start ? Mm.

S2: Well , I wish I could tell people not to worry. And but that is Unrealistic. We are all worried. Um , so what I’ve been doing is I’ve been sort of channel having helping them channel that anxiety into preparedness. So with the nonprofit that I work with , we created a practical guide , a brochure , um , that lists different little steps that they can take right now to be prepared for worst case scenario. Um , we’re talking about , like , having a power of attorney. You know , if they have children and there’s only one parent in the household , or both parents might be , um , taken away , access to bank accounts , having their emergency contacts organize , you know , their employer information , all these , like , small steps to what they do is they restore a sense of agency. Uh , so it’s it’s not the same when they are approaching a crisis unprepared. Then when they have some degree of at least practical preparedness and emotionally , I’m encouraging , you know , sort of like a mindset , a mindset shift. So not denial , but choosing to focus on what remains within our control. Um , I , I love the book , uh , Viktor Frenkel book. He was a , um , survivor , a Holocaust survivor , and he wrote the book , um , Man’s Search for meaning and may have butchered the the title. I’m sorry. Uh , but anyway , he wrote about finding meaning , even in unimaginable circumstances. And the importance of having a sense of purpose , uh , is , you know , being there for the children , pursuing a dream , helping others , like being aligned with one’s values. And that is what , what can sustain someone , even when the future seems so bleak and so uncertain. So. And the one thing that I valued the most from that was that , you know , there are things that can be taken from us physically , but our our memories , our our feelings , our values , those cannot be taken. And that perspective really helps prevent that paralysis. So that’s what I’ve been focusing more on. Hmm.

S1: Hmm. You’re also doing a lot of work to educate mental health providers about how to support immigrants.

S2: Um , the way that we ask about immigration status matters. So , for example , I was giving a talk this past weekend at the San Diego Psychological Association and , and somebody mentioned , um , talking with someone and saying like , are you are you a citizen , permanent resident or undocumented ? You know , something like that , like giving options and and being able to ask in a way that does not feel accusatory That that normalizes different experiences. It reduces the stigma. And and also providers need to also educate themselves about the realities that immigrant families are facing. There’s a tendency to feel more more so before than now. Now it’s becoming a little bit more prevalent. But to feel that this that’s them and this is us , it feels very , very detached , very external. And so to be able to see how this is impacting US citizens , U.S. residents , like all of us , not just the family , but the the social circle , their immediate circle. And when when clients are living in real fear , dismissing that fear is is not therapeutic. And by dismissing I feel even saying like , oh , but you shouldn’t worry or you know , something with a good intention , right ? But , you know , acknowledging it while helping them regulate emotionally.

S1: And acknowledging that in and of itself is important. I’ve been speaking with Mariella Shibli. She’s a clinical psychologist and founder of the non-profit Immigration Psychology Partnerships. Mariella , thank you so much.

S2: You’re welcome. It’s been a pleasure.

S1: Still to come. A new lawsuit into a popular Costco item is bringing attention to misleading food labeling practices. We’ll talk about that when KPBS Midday Edition returns. Welcome back to KPBS Midday Edition. I’m your host , Jade Hindman. No artificial flavors , no preservatives. Labels like that often guide what food we buy and what food we don’t. They imply the food on the shelf is safer and healthier. But is that always the case ? Recently , two California shoppers filed a lawsuit against Costco for claims their popular rotisserie chicken was preservative free. Turns out that wasn’t completely true. And now Costco has since changed its labeling for it. Bottom line it can be hard for us to tell what’s really in these foods underneath the labels. Joining me now to talk more about it is Professor Aaron Gross. He is the director of the center for Food Systems Transformation at the University of San Diego. Aaron , welcome.

S3: Great to be here.

S1: It’s so great to have you.

S3: Specifically , in the Costco case , it was related to sodium phosphate and carrageenan , which they claimed were doing things like improving quality but also have a preservative function. Thus , the no preservative sign was dubious. Now , Costco hasn’t admitted wrongdoing. The case is in the early period. So it’s it’s it’s indicative of the problem , but we don’t yet know there will be a good outcome. Huh.

S1: Huh. Very interesting. Um , also , you know , like certified organic is a common term we see with many of our foods that that tells us that the food is free from maybe pesticides if it’s produce or antibiotic steroids if it’s meat. What can you tell us about food labeled as organic and what does that actually mean ? Yeah.

S3: So organic is one of the labels that’s well regulated. That actually means some things. Now it might not mean always what we want it to. It does mean indeed what you said. If it’s produced it’s not going to have pesticides on it. If it’s an animal product , it’s not going to have been bad antibiotics. But it might have , you know , been a chicken that lived its entire life in an enclosed building , you know , in a cage or , you know , under under conditions most of us wouldn’t consider humane. There are some laws that in about five years associated with organic will. It will address some of those issues. But for the most part , if you’re thinking organic means they lived a natural life. They’re on a farm , they’re on pasture. It doesn’t mean that , but it does actually mean some things. Unlike a lot of claims , which are just marketing and confusion.

S1:

S3: Unless you have the resources to to mount a class action lawsuit. It’s it’s basically you’re going to get deceived. Yeah.

S1: Yeah. Before I get into the conditions about the animals , I’m curious about the health impact of preservatives and antibiotics , steroids , pesticides , all of that. What kind of impact does that have on us ? Yeah.

S3: So the preservative case with Costco is is significant , not because it’s likely to be a health problem for most people. The the levels of preservatives they were using , the kind aren’t , you know , big ticket health worries. But for some people , for example , folks with certain kidney conditions , it’s a really big deal. So that sign that said no preservative was letting them think , oh yeah , this is going to be safe for me. I have a condition. I need to be more cautious. And that’s where the deception really becomes significant. The you know , the big issue here is that we can’t trust a sign when it says no preservatives. The laws just aren’t in place to really make that reliable. It’s so technical. And notice that the way Costco responded to this was not to alter the product , but to pull that no preservative sign. It’s very hard to get product altered , and that’s ultimately what people really want who are fighting about these labels. Yeah.

S1: Yeah. Okay. Um. Very interesting. Earlier you mentioned the lives of of livestock. Um , for foods like eggs and chicken , I often see cage free or free range on containers. Can you give us a clearer picture of what those designations mean for animals ? Yeah.

S3: So cage free and free range don’t mean a lot. Mhm. Cage free indicates that it the animal wasn’t in a cage. But for example pretty much all no chickens are raised in cages in terms of the meat. Chickens if you buy eggs. Yes. No. You know cage free is meaningful. So often you see cage free on a product where that’s irrelevant. Free range is one of these things where people have an idea it means the animal was outdoors , but that isn’t necessarily the case unless you see it tied with another label. So there’s a third party certification called Certified Humane if you see Certified Humane and you see free range on a package , that means that free range claim has actually been verified by Certified Humane and will mean the animal had outdoor access , still doesn’t mean the animal actually lived on pasture the way you might picture. If you see that certified humane label and it says pasture raised , then it might be closer to what you’re picturing. But if you just see pasture raised or free range or cage free , it doesn’t really mean much at all. And , you know , be hard for most folks to remember the details I’m throwing out here. What’s really we’re learning is you have to do some research to know what these claims mean. It is possible to find out that some of them are meaningful. Most of them are not. Right.

S1: Right. You know , thinking about all this , I mean , do you recommend , you know , buying food from local farms and , um , farmer markets , farmers markets. I mean.

S3: If you can go to farmer’s markets and spend some time to get to know the farmers , that’s amazing. Not all of us have that ability , right ? That’s what I would be you know , realistic about there. So absolutely applaud that. And we do have some amazing farmers markets. And depending where you live in San Diego , that can really be an option. But most folks don’t have that kind of time to invest in their food choices , which is why it’s really shameful that we have a system that doesn’t allow someone just to go to a supermarket and buy safe and healthy food. That means what it is , what is labeled.

S1: Yeah , well , you feel there. There is , you know , a wide disconnect between most people’s values around food and how our food system actually works. Tell me about that.

S3: So , you know , familiar entities we hear about all the time in relation to food , like the USDA , the US Department of Agriculture , not that long ago represented kind of the interests of the majority of the country. Now , at the time , the USDA had a dual mandate. It still does to protect Consumer health and promote big business now or promote business rather. 100 years ago that wasn’t big business. So promoting both consumer health and the farmer , when you know 75% of people are farmers , make some sense. Now we have that same system in place where the USDA today is charged with protecting consumer health and promoting , you know , farm farming as a business. But now those farmers are big , you know , nameless , faceless corporations that don’t even treat the folks who are actually , you know , raising the animals or involved in processing very decently. And it’s them that are getting the protections and benefits. And what this has meant is kind of year on year , decade on decade. The system has gravitated towards corporate interests away from what an ordinary consumer would want , even just in terms of , you know , price , convenience , safety and and just completely strayed from broader values about caring for the land , protecting animals , giving farmers a good life. These things just have disappeared , and most of us still have a sense of there being something like a family farm. You’ll hear from our government that many , many farms are family owned. You know , a family can be , you know , a billionaire that owns many , many , you know. And so we basically have hollowed out what used to be kind of a backbone of allowing ordinary people to build wealth and , you know , put their labor and energy into a business and grow it and have turned food into this unrecognizable system. Yeah.

S1: Yeah. Well , as you talk about , you know , corporations , I’m wondering how the globalization of our food and resources has impacted what we get on the store shelves has impacted the supply chain of food. Yeah.

S3: Yeah. Just like those labels are opaque to us , the ultimate kind of origin and ownership of our food has become opaque to us. So one of the biggest stories here is Smithfield , which is a , you know , the largest pork corporation in the world. Totally transformed the American pork industry. And I went to school in Iowa. About 80% of farmers were put out of business in a period of a couple of years. As you know , pork kind of went big and had to kind of get bigger , get out. And , you know , at least you could argue in that original phase that maybe there was some advantages to the pork industry becoming big in America. But the ultimate end of the story is Smithfield is bought by China that now owns , you know , 1 in 4 pigs in America and is clearly part of bigger kind of plays around political power. The this is , you know , in the background of why we can’t figure out , you know , what no preservatives mean. Why are animal labels ? Animal welfare labels aren’t realistic. We we have a system that has become opaque because that really serves corporate interests. And that’s true at every level from , you know , the individual consumer to folks really trying to worry about food security at a national level. Interesting.

S1: Interesting. What concerns you most when it comes to food safety and the availability of it as well ? Today.

S3: The most concerning thing is the way. So most of our dangerous pathogens in terms of food safety and , you know , food safety is the thing that that actually kills people. I’ll focus on one pathogen specifically because it’s such a clear case , which is salmonella , which everyone probably has has heard of. We have more than a million salmonella illnesses in the US every year , and a couple hundred deaths. More than 200 people die from lethal forms of salmonella. This is a problem we actually know how to fix. It mostly comes from chicken. So , for example , according to our centers for Disease Control , one in every 25 chickens on supermarket shelves is contaminated with salmonella. You need to treat it like a biohazard. According to research by Consumer Reports. It’s quite a bit higher than that. So we know our chicken supply is regularly contaminated with salmonella. Now why is that ? Well , there’s some some deep answers that have to do with ways that allows production to happen in a way that makes things cheaper for the companies and allows them to make a lot more money. So they want to preserve it , not because they’re so interested and not taking care of salmonella , but because it preserves a model in which the animals live in , you know , dismal , dark and dirty conditions. And , you know , they can still keep them alive and healthy because they’re feeding them antibiotics. And then even if they have the disease when they’re being slaughtered , it doesn’t affect the price of the product. So they have major incentives to preserve this. And all we would have to do regulatory to kind of fix this is reclassify salmonella into an adulterer. I don’t know what it’s currently called , but it’s not an adulterer. And because it’s not an adulterer , and even though we test it plants and we know they’re failing , the product coming out of them has salmonella. If there’s nothing the government can do. And if we change this to an adulterer , the government would have actionable power. But the Trump administration pulled a roll in April that was going to do this and so on goes the problem with a million plus people getting ill with salmonella. And this is just indicative of , you know , the most immediate health risk where you could actually , you know , die. Yeah.

S1: Yeah. It’s horrifying. Um , briefly , I’m so curious about this. Um , because in addition to your work on on food and with food , you’re , you’re a theology professor. So how do those two things intersect for you ? Yeah.

S3: The way I got into food was ultimately an interest in how human beings relate to the natural world , particularly how we relate to animals. And it turns out that most of the way we shape the natural world , most of the way we impact climate change , shape the oceans , the land , the air , the water , our microbiome is through our food system. It’s this rather obvious thing from a kind of material science point of view. But somehow I was taught to think food as just this kind of personal preference. You know , pick what you like. It’s it’s not something that matters , but it turns out food really is the main way we shape our relationship with life on Earth. It’s today , you know , more than 90% of mammals , more than 90% of birds on the planet are the ones we raise for food. We have , you know , altered the Earth and made it into a farm. We sometimes in environmentalism picture it as a factory , but there are factories there. Significant. But it’s mostly we’ve turned it into a farm. So how we choose to shape our food system is a moral adventure and a moral test , as well as a , you know , delicious adventure.

S1: It’s very interesting. And this is part of the conversation. I could go on for at least another hour with , but we’ll have to pick it up at another time. Aaron Gross is a professor of theology and director of the University of the center for Food Systems Transformation at the University of San Diego. Aaron , thank you so much for this very interesting and informative conversation.

S3: Delight to be here.

S1: Up next , we’ll talk about the ways AI is being used for medical advice in health care with Doctor Eric Topol. KPBS Midday Edition is back after the break. Welcome back. You’re listening to KPBS Midday Edition. I’m Jade Hindman , so it’s been a little over a month since OpenAI launched ChatGPT Health. The new feature allows people to upload their medical records and wellness app data. Then ChatGPT can look through that data and give health advice based on that information. So what can AI chatbots really tell us about our health ? I’m joined now by Doctor Eric Topol. He’s the director and founder of the Scripps Research Translational or Translational Institute. Doctor Topol , welcome back to the show.

S4: Thanks , Jade. Always good to be with you.

S1: Always glad to have you here. So you’re an expert on AI in medicine. In fact , you wrote an entire book about it years before ChatGPT.

S4: One time , his overall health status was ranked an F and then a B , and then a D with all the same data. So it was discouraging. And one of the main pieces of data , as you mentioned , Jade , was his health. Apple health data with his sensor data from his smartwatch. And that all got messed up , so it wasn’t a good start. I’m sure it’ll get better , but I don’t think we want to rely on the outputs right now because it’s very inconsistent , making a lot of mistakes. Wow.

S1: Wow. Well , uh , with it’s not with it not being so reliable. Still , more than 20 , 230 million people used ChatGPT for questions about their health and well-being every week , according to OpenAI. Why do you think more and more people are turning to AI over , say , you know , Google or other online resources. Right.

S4: Right. Well , so now we’re talking a difference about like a new platform for health that ChatGPT introduced versus what has been in place and keeps getting better since the original ChatGPT back in late 2022. So over these years , we’re talking about three and a half years almost. Um , the , uh , expectation just keeps growing. And of course , a lot of people can’t reach a physician or they did get their data back , let’s say their lab data back from their visit to a doctor , but they don’t know what it really means. So they want to check , or they’re preparing to go to a doctor and they want to make sure they have all their questions lined up. And , uh , you know , check out the areas where there are some concerns. So it’s very helpful for those things. Well that’s where these different AI chatbots really do help people. But the question is , how far can you go with it ? And can you get like a virtual coach where not at the point of a virtual health coach yet ? Hmm.

S1: That’s interesting. Um , you know , I mean , you mentioned that , you know , these the chat bots aren’t always so reliable.

S4: That is , a person can put in all their data or a family member’s data , and sometimes a diagnosis have been very elusive , will be at least brought out as a possibility or the the actual diagnosis. So I’ve seen it work really well for that in some cases. On the other hand , you know , sometimes it’s very misleading. Uh , it cites uh , uh , articles that have nothing to do with the question or they’re , they’re made up. So it is what we call jagged. That’s the term that all the AI folks like to use. It’s inconsistent. It’s getting better. It’s going to be more and more important. And of course , it’s not just ChatGPT from OpenAI. There’s cloud health , there’s Google DeepMind , there’s going to be all the all these companies working in AI. The tech titans will have specific health and medical platforms for the public.

S1: Um , what do you think it’ll take to make these AI models more accurate and medically aligned ? Because , as you mentioned , you know , they’re still in their early phases.

S4: Yeah , that’s a really good question , Jade. So it was funny is that the OpenAI folks , uh , contacted me and we had a zoom , uh , earlier this week , uh , because they weren’t happy with my critique , right ? So we had a little powwow and they admitted that they advanced the model without really what they called the pipes. That is getting in all the sensor data. So they’re fixing the problem. And so I think , uh , eventually this is going to be of great utility for people for varied , uh , reasons. You know , whether the the medication that they got prescription for is the best medicine and the best dose and just a myriad of things. But if you’re relying on it to be your main health guide , without any consultation with the medical community , that at times can be tricky. To your earlier question , is there ? So it’s so hard to connect with physicians now , primary care physician could take weeks to get an appointment. Or if you have a question , you know , that is pretty straightforward about your Data about your concerns. This is free. It’s quick. It’s often correct. So of course it’s it’s a good choice for a lot of people. And the good part is democratization of AI. Over time , it will get considerably better than it is right now. Of course , there’s the issue of privacy and security of the data that people could be concerned about , and I understand that totally , because if you put in all your medical record data and your medications and labs and all that , how do you know that it’s not going to leave that site and be brokered or sold or leaked or whatever ? So there is a concern there.

S1: Yeah , it’s a legitimate concern. What if they sold it to insurance companies ? And I mean , yeah , yeah , there’s there’s a lot that could happen there. Um , but ultimately you see the potential of AI really making , um , care and health care more accessible. Absolutely.

S4: Absolutely. We need it because , you know , with the way our population has grown older and more complex , and we have inadequate , uh , physicians and clinicians to support our population. And that’s actually a global problem. So we have to get this right. And I think it’s well on its way. But people should not have a blind trust here. Uh , you know , and one thing I always recommend , Jade , is whatever you put in , do it at least 2 or 3 times to see if you have a consistent answer. Um , and also try different platforms. You know , you could go to Gemini , you could go to , uh , Claude perplexity. So don’t always rely on the same one , because if you find the same answer from multiple platforms or multiple times in one , that’s helping you to know that it’s it’s got veracity. Mhm.

S1: Mhm. Well , you know , and I got to say I recently used ChatGPT to get a diagnosis on an ailment I had by putting in all the symptoms and was quite pleased with that because once I took that to the doctor , it made the process a lot faster and a lot easier. So I can see the promise in this. But , you know , zooming out here. Oh go ahead.

S4: Yeah , I was just going to say , you know , the prototype for superhuman performance in AI is actually the Waymo car , right ? Which , by the way , San Diego somehow or other has not approved , which I can’t believe since it’s safer than human drivers. But that took or 12 some years to get that right , to make it safe and make it , you know , exceptionally , um , useful. And so remember here for health. Oh , these chatbots didn’t start in health. They were just generalized. So it’s going to take a little while just to keep iterating and getting it better and Better models. But it will get it. And already it’s making , you know , lots of contributions to advance people’s health. So we’re we’re in a good place , but it’s going to be far better in the next couple of years. Right.

S1: Right. And when we talk about the broader use of AI in health care on your Substack , Ground Truths , you recently wrote about the use of AI in mammograms. Talk more about that and the evidence in support of its use.

S4: Yeah , this is amazing. We have such strong evidence that every mammogram , besides the radiologists interpretation , should include an AI interpretation , because we know from a randomized trial of over 100,000 women , we know that it’ll detect cancer better , more accurately , it’ll prevent cancers and follow up. We also have an AI tool that , in a normal mammogram read out by radiologists , it will say , well , it may be normal now , but actually there’s a very high risk in the next 3 to 5 years. And so that requires close surveillance. And then the other thing added to all of that is that AI can say whether there’s calcification of the breast artery , which is a very important risk factor for heart disease. So all in all , every mammogram should have these outputs. And what’s interesting is hardly any women get this information. And if they get any of it they have to pay extra out of pocket , which isn’t right. So our country has not gotten aligned with the data here. And we really got to get this moving. And that Substack I wrote , over 90% of of the respondents felt that this should be part of every mammogram. They should get the AI interpretation in addition to the radiologists. Hmm.

S1: Hmm. You know , ChatGPT , um , aside from all that , can also give scores for longevity , which is another field you’re an expert in. I’m just curious what your thoughts are on that. Yeah.

S4: Yeah. I don’t think we want to go to a longevity score. Talk about inaccurate. Um , now , I actually I don’t like the term because that’s not the goal here. We don’t aspire to be 120 or 100 if we don’t have a good quality of life. Right. So that’s why I really push health span. And the book I wrote , Super Agers , I didn’t want to have longevity in the subtitle , but the publisher , you know , just said it has to be because that’s the topic of the day. But health span is where it’s at. And as you know , the average American ends their health span of not having that because they have an age related disease , heart disease , cancer or neurodegenerative disease by age 64 , that’s the average , but their lifespan average is 79. So we have 15 years of loss of health span. So what we should be talking about is how do we extend the health span so that it’s as close to lifespan or longevity as possible ? Why don’t we get that right before we start talking about living to 100 ? And I think we can and we’re excited about it. We’re going to be starting an Alzheimer’s trial prevention next month. And that’s basically because of so much exciting things that are happening in this prevention world , and how we can extend health band without neurodegenerative disease. Hmm.

S1: Hmm. I know last time we spoke , we talked about health span and blue zones , which weren’t so sure , really , really exist. But but there has been a lot of talk about blue zones lately locally. Um , San Marcos is exploring this Blue Zones approach. And I know you interviewed the founder of Blue Zones not too long ago , which you posted about on your Substack. In the last minute we have here.

S4: He’s a very charismatic guy and he’s a good storyteller. And , you know , he’s built this over 25 years now. The problem is there’s two issues. The data about these people with extreme lifespan isn’t well confirmed in these different blue zones like Okinawa , Sardinia and other places. That one is not that important because at least if we know these people were of advanced age. But the other one , which you alluded to is the business side of it. It’s become a big , big business. And they’ve approached San Diego State and then now the community you’ve just mentioned , they charge a lot of money to become certified as a blue zone over five years and millions , tens of millions of dollars. And I don’t think that this business is what you know , it’s not it’s not what it’s about , really.

S1: Yeah , we’re going to definitely have to pick this conversation up later. I’ve been speaking to Doctor Eric Topol. Doctor , thank you so much. I always appreciate you.

S4: Thanks very much , Jane.

S1: That’s our show for today. I’m your host , Jade Hindman. Thanks for tuning in to Midday Edition. Be sure to have a great day on purpose , everyone.