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Research and Justice For All is a podcast from Health Affairs that provides perspectives on how to dismantle unjust systems and structures that have long impacted health outcomes in historically marginalized populations. Hear how to challenge injustices in health care – rooted in racism, sexism, ableism, and other forms of exclusion – through research, evidence, community-building, and other potential and innovative solutions.
Each season of the podcast is sponsored by organizations dedicated to eliminating health inequities.
This is Research and Justice For All, season 2. And I'm your host, Ria Boyd. Thanks for joining us today. Today, we're going to be talking about the connections between social isolation and well-being, particularly for our nation's young people. Now that we all find ourselves 4 years deep into the COVID 19 pandemic, and for many of us, some of our loneliest years, I'm thrilled to be talking with our guests today about what that means for us and what that means for our kids.
Rhea Boyd:So I'm grateful to be joined by doctor Sarah Hemminger. Doctor Hemminger is a social entrepreneur and scientist who co founded THREAD, a nonprofit based in Baltimore, Maryland that utilizes the power of relationships to support young people in overcoming extraordinary opportunity and achievement gaps. Doctor Heminger, Sarah, welcome to the show.
Sarah Hemminger:Thank you. Thank you for
Rhea Boyd:having me. I'm actually really excited to talk about this topic. But before we jump into it, tell us more about you. I know you wear a number of hats. Tell us more.
Sarah Hemminger:Oh, well, I wear a hat as a adjunct faculty member at Johns Hopkins in the Department of Biomedical Engineering, where we support, the entire department, not just students, but faculty and staff as well in learning how to bridge and bond across lines of difference. And then, of course, through my work with Thread, another hat I wear is as a mom to my 10 year old daughter and, wife to my high school sweetheart. We've now been married 25 years. I am an introvert and, someone who really loves learning and problem solving. I would say, I'm very focused on process and less outcome.
Sarah Hemminger:I I I always like to say 1 +1 should equal 47. So kind of taking the world view that all of the things that we really need to be a thriving community exists, and it's just how we're actually putting the pieces together to get to a more equitable society. So that's kind of how I approach life and work.
Rhea Boyd:It's interesting to be an introvert and somebody who studies social connection. Is there any is there anything there? Is it that, even though you're an introvert, you know the the benefits of connection because you study it and now work on it in your nonprofit? Or
Sarah Hemminger:I mean, THREAD was founded out of my deep sense of isolation. I was, at the time, working on my PhD. I'm a computational neuroscientist by training, and what happened is that I just a lot of things that I had not dealt with from childhood, a lot of very traumatic but also miraculous experiences that I hadn't really worked through, BubbleUp, when I was in graduate school, and I was just desperately trying to find a place where I could be my full self, where I could just kind of take a deep breath, relax my shoulders, not have to put on a mask, and really just find my people. The reason that had been such a challenge for me is I, you know, I was born not breathing and had injuries to my face, and the birth my birth was so traumatic for my mom and dad that my father, who's a plumber, decided he would never let another physician, deliver one of his children. So my father delivered both my younger siblings in my parents' bedroom.
Sarah Hemminger:If you were to ask him about it, he would tell you it's just plumbing. And that'll give you kind of a sense of the counterculture family I grew up in. But, a few years later, around my 8th birthday, I was actually abducted from my home in the middle of the night, And I'm part of this very small percentage of kids in the 1980s who was fortunate enough to return home alive. And I came home, and my abductor had come in through a window and walked out the front door. So I walked back in through the front door.
Sarah Hemminger:And I went and told my mom and dad. I said, you know, I've been abducted. I've been kidnapped. They said, no. No.
Sarah Hemminger:No. You haven't. You just must have had a bad dream. Go back to sleep. You you know?
Sarah Hemminger:You you no one kidnapped you. And this went on for some time. It would you know, at some point, I got quite hysterical. And at some point, my father just happened to catch a glimpse of my feet, which were completely black because I had been walking home barefoot in the middle of the night from where my abductor had left me, and he just began weeping because he knew at that moment that I had been telling the truth. And so, you know, around that same time, which may what made this even more complicated is that the church we attended, my parents found out that the pastor was misusing funds and doing a number of other very abusive things.
Sarah Hemminger:And when they revealed it to the congregation, instead of firing the pastor, they decided they would shun our family. So from around 8 to 16, I would go to church multiple days a week, and the congregation was instructed not to speak to me. So adults, children, my own family, my aunts and uncles, my cousins, and it was just, you know, as though I did not exist. And I was very, very fortunate in that I had a close close relationships with, you know, my immediate family. But that feeling of just having gone through something so traumatic as being kidnapped, and then the, you know, religious community that you would think would wrap their arms around a little kid during that time and hold them instead treated me as though I didn't exist.
Sarah Hemminger:And so I I I found myself in graduate school with all of that really just not dealt with and not really sure how to find my people and who my people I didn't know who my people were, and that's where it kind of intersects with my husband. He had grown up, in a working class family, and then his mom was in an accident a week later in another accident. And she became you know, she couldn't walk for a while, so she couldn't work. So she lost her job, then they lost their home. She became addicted to Dilaudid, and things just completely spiraled out of control.
Sarah Hemminger:And this kind of 18 month period coincided with my husband's transition into high school, and he failed all of his classes and was gonna drop out. And there was a group of teachers that were just like, yeah. No. And they became really an extended family for him, and he ended up becoming a straight a student, varsity athlete, going to the Naval Academy. And so one day, I was just driving into to graduate you know, into lab in graduate school and was stopped at the streetlight, and I just noticed Dunbar High School was on the left side of the street, and Hopkins was right in front of me.
Sarah Hemminger:And the thought that crossed my mind was, I bet my people are in that building. And I didn't mean Hopkins. I meant Dunbar High School that there must be other young people who are exceptionally talented and brilliant and capable, but that are dealing with things outside of school that make it really hard for them to focus on their own, you know, on their own journey of growth and development. And and so that's anyway, that's how Thread started. And I think, you know, it's so unexpectedly spectacular is that now 20 years later, that initial group of young people that I met are now my colleagues.
Sarah Hemminger:So they're on our staff. They're my bosses. They're on our board. Their children and my daughter are all around the same age, so they're also my closest friends.
Rhea Boyd:Wow. I did not know any of that. And, first, I'm just sorry you went through so much at such a young age. Tell us more about how and you've kind of touched on this already, but tell us more about how that led to founding an organization. You know, some people might find their way through that through counseling or maybe friends or a new church community.
Rhea Boyd:But you decided to do something specifically with young people and founded Thread. How did that begin?
Sarah Hemminger:Before answering that question, one thing you said that really, I think, is at the core of the work we do, which is this feeling of not being believed when I was trying to convince my parents of what had happened to me. That is what the young people in THREAD go through every day, 20 fourseven, 365 days a year. They're saying, this is what happened to me. This is my lived experience. And what the world reflects back implicitly, explicitly is, no.
Sarah Hemminger:That didn't happen. And And so my brain can't even for me, that feeling of not being believed was just a matter of minutes, hours. For our young people, it's a lifetime. And so I think that's the thing that, like, what we're really about in thread and what we're really trying to accomplish in our community is space and place where people feel very seen and known and loved. Yes.
Sarah Hemminger:And then to answer your question about how did it start, how did it turn into an organization, when we started, I didn't even know what a 501c3 was. There was no intention to start an organization. That's not what I thought was happening. I just wanted to hang out with some high school students who I thought had a lot of promise but that were academically struggling. So I, reached out to the principal of Dunbar High School, and I just said, could you please introduce me to 10 young people who rank academically in the bottom 25% of their class, so that we might, you know, work on on that?
Sarah Hemminger:And instead of 10, he gave me 15 over the course of a matter of months, and I had absolutely no clue what I was doing. On the 1st day of thread, I remember calling my father and saying, I what am I gonna do with a bunch of teenagers? And what I did was I ended up just putting 3 things up on the the blackboard, academics, community service, and team building, and I just asked them, let's build this together. What do you wanna do? Do you wanna do anything in these 3 categories?
Sarah Hemminger:And so they said they wanted after school sessions to work on their homework so that they could graduate from high school on time. They said they wanted to go to the Maryland Food Bank and, ensure that people had adequate food to eat. They said they wanted to go camping. I hate camping, but they wanted to go, so we win. And so now, you know, 2 decades later, the things that they created on that very first day of thread, we still do.
Sarah Hemminger:We still have after school thread hour sessions. We still do community service, and especially, involving, efforts around food security. And then we always, each year, go camping. So those, you know, those core components started with them, and that's still how it works to this day is that we are constantly working together to cocreate the world that we want to live in. But I
Rhea Boyd:was gonna say is you also mentioned early on that part of the core of Thread is, like, connecting kids across difference. So tell us more about how that happens. Because at first, you took it sounded like the kids have a lot in common and that they're kind of underachieving academically. Are there other critical differences that you guys are either selecting participants around? And then maybe just tell our audience a little bit more about how THREAD functions.
Rhea Boyd:You know, how many young people participate? Do you have other staff? Is this like a brick and mortar place where kids show up after school and go inside, or does it happen at Dunbar High School? Are you at other high schools? Tell us a little more about the nuts and bolts of how THREAD works.
Sarah Hemminger:THREAD enrolls high school freshmen who rank academically in the bottom 25% of their class. To give you a sense of what that means, the average incoming GPA of our young people is 0.76 on a 4 o scale. Then once they are enrolled in THREAD, we make a 10 year commitment to them. So the engagement lasts the remainder of high school and 6 years after. The most radical aspect of our approach is that once a young person is enrolled, we never unenroll them.
Sarah Hemminger:So we know that it takes time to build trust, to build relationships, where people really do truly feel known and seen and loved. And so that's why that 10 year commitment and never unenrolling a young person is so critical. Once they're in thread, there's 3 parts to our model. So the first is that each young person and their family are matched with a group of up to 4 volunteers. So those 4 volunteers could be university students.
Sarah Hemminger:They could be working professionals, individuals who maybe are retired or stay at home parents. But what's important about it is that group together is what we call a thread family, and the thread family might give the young person a ride to school. They might pack their lunch. They might go to an O's game together. The way to think about what the Thread family does together is if you would do it with your own child, we do it with ours.
Sarah Hemminger:If you would do it with your own niece or nephew or your neighbor, we do it with our young people. And then to support, the THREAD family, we also have programs. So our programs include, after school THREAD hours, monthly community service, and then experiential learning trips, like camping, college visits, things of that nature. The third part of our model is, access to resources and opportunities. So, for example, it's difficult to accept a ride to school if you're unhoused.
Sarah Hemminger:So our resources and opportunities team works with pro bono collaborators. So you might have an attorney who represents a family to help prevent an eviction, or, you might have a mental health care provider who, in kind, provides mental health treatment. So it's really to make sure that any barriers to a young person really being able to achieve their goals are removed. The other aspect of it is just equitable access to opportunity. So that might be employment, not just for the young person, but young employment for their parent, or other members of their family, really trying to support that entire unit.
Sarah Hemminger:Okay.
Rhea Boyd:I got it. Wow. This is an incredibly robust program. I mean, when you said 10 years, that's a really long investment in kids. And it strikes me that when you think about the type of interventions that are often funded, publicly funded or privately funded by philanthropy, people often wanna see outcomes on a much shorter horizon than 10 years.
Rhea Boyd:Do you guys follow certain outcomes for your thread families? And have you found that did you land on 10 years because you found that that's the kind of duration of investment necessary to really overcome what kids were facing in their homes and communities?
Sarah Hemminger:So we currently work with a 1,088 young people and their families with the support of over 3,000 volunteers and collaborators here at 7 high schools in Baltimore City. And, you know, when you're building relationships across lines at different so if you think about Baltimore City, where redlining, you know, as with many other places, had such catastrophic implications, we're often physically feet apart. Right? So you might have Dunbar High School across the street from Johns Hopkins, but just functioning as though we are on different planets. And so what what THREAD is really about is there's an opportunity there because we are in close physical proximity, but it's how do we build the muscles, not with our young people, but build the muscles with the volunteers, with the adults to actually build relationships across lines of difference in a way that has, you know, permanence.
Sarah Hemminger:So we're wanting to not just build the relationships between young people and thread, their families, and the volunteers, but we're also trying to knit together the institutions. So it's how do we actually not just build these very strong relationships with individuals, but how do we connect the institutions in a way that they start to function as though they're inextricably linked? Because we believe that they are. It's just not how we're showing up as a society. I mean, this is a fascinating approach, and I
Rhea Boyd:think it's a really interesting way to talk about social isolation. You know, when I first introduced today's episode, I introduced social isolation kind of at the individual level. And when you shared about your childhood experiences, we were, again, thinking at that individual level about what happens to one person who feels disconnected from their family. But now you're describing a threat, it sounds like it also functions at, you know, the community level, that institutions matter and that the lines of difference aren't just between because when you initially shared about threat, I was thinking, oh, the lines of difference must be between the young people, and you're connecting young people from different backgrounds. But it sounds like you're connecting folks from various institutions that actually exist in very close proximity, but are affected by the historic forms of racism that have determined who has certain resources and opportunities and the outcomes that follow that for those folks and who doesn't, and you're connecting people across those lines.
Rhea Boyd:Am I am I getting that right? Is that how it's working?
Sarah Hemminger:Yeah. That's that's exactly right. And I think when we started, I thought I was the only person that, like, was suffering from that sort of isolation. And now you have, you know, our surgeon general declaring an epidemic of loneliness and isolation. The data is overwhelming.
Sarah Hemminger:Right? Being isolated is worse than smoking 15 cigarettes a day or drinking 6 vodkas. And we know that it's even more impactful for individuals who are living in disinvested communities. So it's the relationships are important for everyone. The interesting thing is we've done a lot of internal to your question about outcomes.
Sarah Hemminger:So we measure quantitative outcomes, things like grades, attendance in high school, high school completion. Are you on a post high school pathway? It doesn't necessarily have to be a 4 year school, but it is, are you, an entrepreneur, or are you going into the military or straight to the workforce or getting some sort of certification or licensure? Do you have a clear life path that you are laying out, and do you have the resources to execute on that? What we've seen is with the with the quantitative outcomes so if you look in Baltimore City, for young people who have GPAs of less than 1 point o during their freshman year so remember, our young people have an average of 0.76 during their freshman year.
Sarah Hemminger:Only 6% complete high school in 4 years. 6%. In THREAD, never having unenrolled a single young person, 74% of our young people have completed high school. Sometimes it takes 4 years, 5 years, 6 years, 7 years. We just stay in there because, again, if you would do it for your kid, we do it for ours because these are our kids.
Sarah Hemminger:And I think that's the thing that's been lost just more broadly is, like, we are all interconnected, and all of the kids in Baltimore City are our kids. And when we don't make investments, it's not just harming them. It's harming all of us. We're missing out on a leadership pipeline for the city, but we're also harming our own health in being disconnected. The other thing that we've tried to do over the last few years is really understand what is the critical what are the critical pieces of building relationships across lines of difference?
Sarah Hemminger:And we can distill everything we've learned really into 2 things. The first is that the quantity of connection matters. So if you wanna have a strong relationship I know it sounds so simple. Right? But it took us a long time to, like, do a really in-depth analysis of our own data and realize, like, the quantity of connection matters.
Sarah Hemminger:So we can project if a young person is gonna complete high school 4 years from now based on the quantity of touch points that they have with the adults in thread in a given month. So we know that that is critical. It's less important what the touch points were, whether it's SAT prep or a ride to school or the O's game. What's important is that there's consistency of connection. The second insight is the thing that it's this is where the work really is.
Sarah Hemminger:So the second insight we got we had from interviewing, young people and volunteers, and we just asked them, like, when you're when you're in the car on the ride to school, what is happening? Like, help us understand, like, what what's going on? And what they would describe is on those initial rides to school, the young person felt like they were being helped. And they wanted the ride to school, but the idea of needing help didn't feel great. After, let's say, 10, 20 rides to school, what would happen is they would start talking, and they would start to get to know one another, and they would start to feel a sense of this person knows me.
Sarah Hemminger:This person understands me. They get me. They see me for who I really, truly am. But that's not the transformation. The transformation happened further out.
Sarah Hemminger:The transformation happens in our community when the adult starts to ask the young person for their help. And you might think, okay. How is, you know, this young it just shows our bias. Right? Like, we it's hard for us to imagine.
Sarah Hemminger:How's this young person who's maybe unhoused, food insecure, going to help this adult? But it's a failure of our imagination to see that that's actually the key to, the young person feeling that deep sense of agency, of self efficacy, of confidence. Right? So, and when you think about it from, like, a neuroscience perspective, it makes complete sense. Like, we're our brains are all hardwired.
Sarah Hemminger:We all want to be helpers. We get dopamine. Our cortisol goes down. Like, we feel better when we help, and yet one of the implications of structural racism is that it's told our young people that they're marginalized, they're disadvantaged, they're at risk. They are never to be the helper.
Sarah Hemminger:They are just to be helped. And we're robbing our kids of neurochemicals that we all desperately need. And so we thought, oh, okay. We just have to teach adults how to be vulnerable and ask kids for help and like, voila. And, wow, did we completely underestimate how deeply ingrained individualism is and how difficult it is to to coach and train and teach adults how to show all that we say we call it in threads, showing all the way up being your full self and learning, the skill of how to do that while not impeding on somebody else's ability to do the same.
Sarah Hemminger:And that that's our work. Like, that's the work, and that's why we've also focused on going very deep in one location because our theory of change is that we want to tip the culture and climate of a city. We want it so that that that in Baltimore, the gap between black women dying in childbirth and white women child dying in childbirth closes. That's what we want to see. So the question is, how do we get there?
Sarah Hemminger:And we believe part of it is building these skills so that we truly engage one another in a different way. And so to tip the culture and climate of a city, we're first trying to tip the culture and climate of the institutions in the city by helping people come together across these lines of difference, and support one another in learning and growing.
Rhea Boyd:I mean, this is so powerful. There are a couple of things you said there that I I wanna take just a little bit more time to drill deeper into. The first is that kind of what we were touching on before with the last question is there's multiple forms of isolation. It's not just an individual experience. It's something that happens at a structural level that involves the level of exclusion from certain institutions that is absolutely shaped by our nation's history of racism.
Rhea Boyd:But just as there's multiple forms of isolation, what you just highlighted is there's multiple forms of connection. And I think what you were touching on is that there or what I heard in that and what I started to take away is that it's not just about having a connection or sometimes in the kind of nonprofit Vibey world, people talk about people who are disconnected versus connected. Like, there's just a one size fit all, and you're a puzzle piece, and you're just connected to one person. But instead, the quantity of those connections and the quality of those connections and even more specifically maybe than the quality, like, the nature of those connections is what you started to touch on really matters. And I love that you described what maybe I'll just call the help paradox, which is, like, this idea that people in my in my own work with, young people and nonprofits, as a pediatrician who also does some community based advocacy around the effects of racism on kids, we find something similar, that young people are like, actually, you know, get your help off of me.
Rhea Boyd:Like, I don't want your help and that being the helped person can be a position of sublimation. You know? It can be, one in which our structures of dominance place you in the inferior position. And so I find it very powerful, but also it I find it also in my own work that that reciprocity that's necessary for that young person to have agency and, like you said, the feeling of self efficacy, I also find I think it's it's critical to how they do. What I was gonna say is perhaps we could touch on even more of the different types of connections there are.
Rhea Boyd:I know you had mentioned before we started today's episode that Rash Tedi's work has been meaningful to you and your work. And Rash Chetty also tries to identify the ways that isolation, but also various types of connection can contribute or not to kids' long term well-being, specifically around their upward mobility. I don't know if this is an outcome you guys are following, but, you know, I'll just mention this here in case other folks are interested who are listening. Rasheddy is a social scientist. He works at Harvard.
Rhea Boyd:His lab is called Opportunity Insights. And in August 2022, he had a very fascinating paper about social capital and economic mobility where he essentially found that, like, the exposure essentially, what you're talking about, Sarah, the exposure that young people have at their community level, not in their own household, but at their community level, to parents who have things like employment and to other adults who expose them to certain opportunities or even just ways of approaching school and their future and their life path has one of the most powerful impacts on whether or not that young person earns more in adulthood than their parents did. Can you tell us more about the different types of connection that you think matter? And maybe even if there are specific ways that Raj Teddi's work has influenced how you see the work you guys do at Thread. Maybe 15 years ago, we realized that we could affect outcomes.
Sarah Hemminger:And when I say outcomes, I mean life outcomes, not just completing high school and a post secondary pathway, but breaking the poverty line, meaning earning at least 300% by the age of 40. If we could just influence one decision, and that decision is, does a young person go to school today? Because we know if they go to school today, they're more likely to go to school throughout the year, they're more likely to complete credits, and they're more likely to graduate. So if just every day we can influence this one decision, like, that would have a tremendous impact. And so what we realize is and this is just nerding out again.
Sarah Hemminger:But when you think about decision making, this is an oversimplification. There's two things that influence each of our decisions. So let's say the decision for a young person is, do I go to school today, or maybe I stay home and take care of younger siblings, or I go to work because I need to help support my family, or maybe I'm out on on the street. When they're making that decision, the first thing they're gonna look at implicitly, explicitly is reward. So maybe I'll get $200, today if I am on the corner.
Sarah Hemminger:But if I go to school, graduate, get into college, graduate, get a middle class job, I'll get $400 a day. Right? But we know that the 400 is actually less valuable than the 200 because it's delayed. Right? It's so far out in time that its value is less.
Sarah Hemminger:And so when it comes to reward, we're already losing. So a lot of what we do in thread is try to influence reward in real time. That might be on that ride to school bringing breakfast. That might be making sure that they have a place to do their laundry so that they feel confident when they go to school that day. It might be as simple as just looking a young person in the face and saying, I can't imagine how hard it was for you to get up this morning, and I am so proud of you for just getting in the car to go to school.
Sarah Hemminger:But it's trying to provide that real time reward. But the second thing our brains look at is likelihood. How likely is it if I sell drugs today, am I gonna get $200? Or how likely is it if I go to school, graduate get into college, graduate, get a middle class job, am I gonna earn $400? And what our brains do is it looks at our dataset.
Sarah Hemminger:Right? It just plays back like a movie in our head. If I've never known anyone who's graduated from high school, gone to college, graduated and gotten a middle class job, then I think the probability of ever getting that $400 a day is 0. If I know a bunch of people who have gotten that $200 a day for being out on the street, probability is really high. So why would you delay gratification for something for a reward that you don't believe ever is going to come?
Sarah Hemminger:Right? So what you're what what kind of referring to is it's not just that we try to provide rewards in real time to influence a young person's decision, but we try to shape the likelihood function that they're working with. Right? So to your point about, like, Shetty's work, it's do you know a sanitation worker? Do you know an attorney?
Sarah Hemminger:Do you know a physician? Like, really, you know, there's a time in thread. We used to laugh about this when the majority of us were all, scientists and and medical students. And if you were to ask a young person in thread at the time, what do you wanna do when you grow up? They'd say, I'm gonna be a doctor, but that's because that's what we were all doing.
Sarah Hemminger:Right? And so you say what you see. And so the more exposure points you can have to what the possibilities are, the more you have a chance of not just, like, surviving, but actually finding your purpose in life and really being able to be in that place of doing what you're passionate about and using the skills, the things that you're most, you know, adept at to have an impact in the world, and and those are happy people. Those are really happy people. And I think, you know, one of the the frameworks we think a lot about is Bronfenbrenner's sociological model from 1977.
Sarah Hemminger:And what he showed is that if you want sustained change in any ecosystem, you need it in 5 domains simultaneously. In the intrapersonal, meaning my own knowledge, attitudes, biases, beliefs, the interpersonal, like, do I not only want to be in a relationship with you, but do I have the skills to build a relationship with you? The third is the institutional. 4th is community, and then policy. And a lot of times, historically speaking, we have focused on policy.
Sarah Hemminger:A perfect example of that is Brown versus Board of Education. In 1954, right, you had 2 historically Black high schools here in Baltimore City, Dunbar and Douglas. If you talk to graduates from the early fifties, they will tell you they knew a sanitation worker. They knew an attorney. They knew a physician.
Sarah Hemminger:They knew a stay at home parent. While the neighborhoods and schools were racially segregated, they were incredibly class diverse. And so those data points for young people, that safety net, like, they had all of that. And so, you know, when you don't do the work in these other domains, right, when you don't get people when you just pass the policy and people actually don't want to be in a relationship with one with one another, the problem is you get what has happened in our country, which is white flight out of most cities, followed by middle class black flight. And now those 2 high schools are actually more segregated than they were 70 years ago because they're now segregated by both race and class.
Sarah Hemminger:And now what Shetty is telling us is that the most important thing you can do to support someone in breaking the cycle of poverty is have a relationship in childhood across lines of class. And so we're kind of the big and of policy. You certainly we certainly have to undo, redo racist policies. And in the absence of doing the work on ourselves to actually change our own bias and become aware of it, and make an intentional effort to get to know one another, it won't the policy will never be enough.
Rhea Boyd:It's so funny you say that, Sarah, because, honestly, as you were talking initially, I was gonna my next question to you was gonna be, what are the policy implications of your work? And how you frame that was so useful because when we start to talk about problems that have structural origins, like racial segregation, and how that has affected long term the outcomes of, you know, black folks and other communities of color over decades, if not centuries. We we focus on solutions that try to undo, like you were saying, those long term structural drivers. And we try to do that through the law, through policy, through shifting how our institutions function on the books. And tell me if I'm wrong, I feel like what you're offering is, yes, that work is valuable.
Rhea Boyd:You know, this is health affairs. It's certainly valued in this community. But that there is also work that we need to be doing individually and interpersonally and in our workplace. And so maybe I'll just ask you I think you were touching on this, but if you can just reiterate, you know, for people listening who are interested in getting involved, who perhaps because this is health affairs are thinking of this topic in an academic way where or an advocacy way, like I focus on in my work where the solution is policy. Frame for us what it would look like for a young person, a student, a PhD right now to do something about this interpersonally, or even just within themselves and within the roles they occupy right now that's outside of a major, large, sweeping structural change?
Sarah Hemminger:So I'll share the thing that I'm trying to work on each and every day. A few years ago, it was in the middle of omicron. My dad had just recovered from cancer. We took a once in a lifetime trip to Portugal as a family, so my mom, my dad, my husband, and my daughter. And we were on this cliff and just looking at the most spectacular sunset I have ever seen in my entire life.
Sarah Hemminger:Like, it's one of those things where the nature is just like indescribable. And I think my daughter was maybe 6 at the time, and I kept trying to get her attention and say, look at the sun. Look at the sun. And she just wouldn't turn around. And I kept saying, come on.
Sarah Hemminger:Come on. Look at the sun. The sun. She goes, no, mom. The moon.
Sarah Hemminger:And she kept insisting. And I thought to myself, does my daughter not know the difference between the sun and the moon? And she got so frustrated with me because I kept insisting that she look at the sun, and she grabbed my arm and turned me around. And there, right in front of my eyes, a 180 degrees different in vantage point, was the moon just as bright as the sun. And I think about, again, similar to the relationship with my own parents, like loving relationship.
Sarah Hemminger:And yet, I kept invalidating what she said she saw, because it was so beyond my comprehension that I could be looking at this gorgeous sunset and that she would be looking at the moon. I thought that's not possible. We're at the same place on the planet at the exact same time, and we're looking at 2 things that are so starkly different as the sun and the moon. And so I think about, like, what each of us what I'm trying to do, what I think it's just super simple. When someone says when you say someone, I see the sun, and they say, I see the moon, instead of waiting for, like, all of that tension to build, just take them at their word and turn around and say, can you show me what you see?
Sarah Hemminger:Like, if just an everyday conversation, we could do that. Imagine how things could look so different. And it you know? So I think, like, again, it goes back to a failure of imagination on my part, all of our parts, but it's just understanding that those two things can be true at the same time, that you can have this beautiful moonscape and this beautiful sunset. And what else might be true that we think is impossible?
Sarah Hemminger:Right? And that all it all it would take is us to just build those muscles of turning around. And I think the more we can turn around without asking someone to expend energy to get us to, especially with, like you think about that example in the power dynamic, I held the power because I'm the parent. I held the positional power. And so I think individuals sitting in positions of positional power have a greater responsibility to turn around, do it quickly, succinctly.
Sarah Hemminger:And when someone says, I see the moon, say, help me understand. Help me see it too.
Rhea Boyd:Wow. I was just gonna say I love that phrase, and I just wanna repeat it. Can you show me what you see? Like, that's a very powerful starting point for essentially what it sounds like Thread does, which is connect people across lines of difference. This is doctor Sarah Heminger, everybody.
Rhea Boyd:Thank you so much for being with us today and talking to us about social isolation, young people's well-being, and the powerful work you guys are doing in Baltimore at Thread. It was really an honor to learn from you today.
Sarah Hemminger:Thank you. It was an honor to be with you.
Rhea Boyd:This is Research and Justice for All from Health Affairs, Season 2. If you like what you heard today or you're interested in our future upcoming episodes, be sure to click subscribe or send it to a friend.