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�°IJʿ������’s Department of Biology and Global Public and Environmental Health Program welcomed Dr. Jerome Adams, former U.S. surgeon general, to campus on Oct. 6 to discuss his work leading national and global health policy, as well as his personal background, navigating health issues and championing the health of the vulnerable.

During the event, held both on campus and via Zoom, Adams asserted that we make decisions every day that compromise our future physical and mental wellbeing, tending to prioritize our financial wellbeing above everything else. Furthermore, according to Adams, healthcare only determines about 10% of our overall health, with the remaining 90% shaped by environment, behavior, and other factors.

To illustrate his point, Adams drew examples from his experience working in a trauma unit, where he saved the life of a patient with a gunshot wound, only to have the patient return a year later with a stab wound from the same gang violence. He described another patient, who needed significant medical intervention following a severe asthma attack. Afterward, she returned to a housing complex filled with secondhand smoke. 

“I realized that these problems that patients were having were the results of environments and inequities that make it difficult for people to lead healthy and productive lives,” Adams says. “Their choices and outcomes were in large part determined by their circumstances. Their zip code was more important than their genetic code or even the choices that they themselves wanted to make.”

In response, Adams urged a focus on these upstream factors, because they stand to have more of an impact on helping and changing people’s lives while also boosting the economy, which currently sees $1 in every $5 going to health care. Adams noted that these dollars are being diverted from retirement funds, educational opportunities, and tax bases. They echo the loss of productivity among workers dealing with chronic disease.

Adams highlighted the ways in which citizens can create and advocate for high-opportunity neighborhoods, where good health is woven into the fabric of everyday life and encouraged through better policy, business, and employment practices.

These insights are based on experiences within Adams’ own family and community: limited healthcare access, chronic disease, substance-use disorder and ensuing stigma, tobacco addiction, mental illness, and the opioid epidemic. He also draws on his professional experience as former Indiana state health commissioner, U.S. surgeon general, and leader of the 6,000-person U.S. Public Health Service during the beginning of the COVID-19 pandemic. He carries on this work today as a presidential fellow, executive director of health equity initiatives, and faculty member at Purdue University. 

“When Americans lack the opportunity to reach their full potential, we all pay the price,” Adams reminded students. “It hurts us all when we don’t support a healthy environment. We pay in suffering and premature death; reduced productivity and higher medical cost; and decreased economic competitiveness. We even pay in terms of national security. We cannot change individual health unless we address community health.”