One of the perks of working in futures is that curiosity is an asset. You’re constantly searching for signals of what could be on the horizon. You’re constantly asking questions about potential transformations, disruptions and constraints that could create unanticipated scenarios that fundamentally alter the world that we live in.

I have a few areas that I’m listening to and asking questions about that I see as having an outsized impact on the future of health.

Looking at issues like resilience, emerging communities, ethics of AI/ML/PM, SDOH, #futureofwork , workforce development, etc.

1. Labor and work. Millennials didn’t ruin the workplace but we are subject to macro-level and micro-level changes that undermine and shift a full-time job with generous benefits as the socially accepted norm. Yes, the future of work will feature automation and augmentation. Technology is not the end all and be all of this shift. We will also need to contend with the creation and destruction of new tasks and jobs as we have new economic actors entering the landscape and old actors both digging their heels in or leaving the workplace. The instability and insecurity that accompanies this shift and new models of work drives greater exposure to hazards as well as the emergence of new threats. For starters, how do we reimagine and redesign benefits amid less job security? How does instability and task volatility affect productivity and feelings of autonomy? How do we replace and/or reinforce social support in the new workplace?

2. Climate change. Climate change is happening and will happen. It’s a question of magnitude rather than occurrence that we must content with presently and in the future. Although climate change has far-reaching consequences that we have already started to see such as climate refugees after extreme natural disasters, there are a host of disruptions and importantly, opportunities that remain to be explored. What are the new risks and new epidemics we can anticipate with environmental volatility and more severe destruction? How can we begin to predict these consequences? What opportunities exist to build anti-fragile systems that benefit from this volatility and reduce the inequitable impact of climate change?

3. Trauma. The nomination of Dr. Nadine Burke-Harris as California’s first-ever Surgeon General elevates the role of trauma in public health discourse as a determinant of health worthy of intervention given her research in adverse childhood experiences (ACEs). Unfortunately, trauma is not limited to childhood as we live through the disclosures from the #MeToo movement about sexual harassment and assault and are forced to shock the entire country to confront its racist past and present through Black Lives Matter. The growing discipline of epigenetics illuminates how trauma is encoded into our DNA, predisposing entire populations to increased risk of life-altering chronic disease. How can we mitigate generational risk with interventions that detect and anticipate these genetic changes, possibly preventing them?

4. Community. The town square, the library, the house of worship, the community center, the social club, the union…all community-based and community-driven institutions either in decline or under threat. These old standbys of social support provided a sense of purpose and belonging as well as grounding history and ritual for the exchange of knowledge and resources. It’s no accident that we see a loneliness epidemic coinciding with the death of these third spaces outside of work and home. Humans are social creatures; this isolation not only leaves people feeling alienated but also drives insularity, making the ingroup fearful of and unempathetic toward people on the outside. Where does technology enable connection? How can we build, share and reinforce values collectively? Where can people look for education and social support that perpetuate positive behaviors and inhibit negative behaviors? What is the role of new rituals in orienting people toward purpose and empathy?

5. Workforce development. The healthcare workforce is in crisis. Unfortunately that is not an understatement. A recent survey showed that 44 percent of physicians are burned out. Roughly a quarter of nurses providing primary care reported being burned out. This is not limited to clinicians. The public health workforce is also disengaged and fleeing the industry. How can we address the profound and growing retention challenges of the health workforce? How does the nature of this labor contribute to life-threatening errors? How can we make the work both safer and more effective while making the experience of the workplace less stressful? What professional development and training would support these goals?

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