- We actually know that today as we speak,
half the world's population lacks access to healthcare.
And about 2 billion people lack access to care simply due
to geographic distance.
And the approach we bring to that is really
around looking at the health workforce
and really looking at
how community-based primary care can be better delivered.
- Welcome to balancing Life's issues.
The podcast Today we are celebrating World Health Day
and this year's theme of my health,
my right reading from the World Health Organization,
this year's theme was chosen to champion the right
of everyone everywhere to have access
to quality health services, education,
and information, as well as safe drinking water, clean air,
good nutrition, quality housing, decent working
and environmental conditions,
and freedom from discrimination.
But why do we need to care about World Health?
A topic that seems so far removed from the safety
and comfort of my home and my community?
Well, as it turns out, I recently became friends
with someone in my community who happens to be the CEO
of Last Mile Health, a global organization whose mission is
to invest in those closest to the community,
community health workers,
and the systems that enable their success.
Her name is Alicia McCormick,
and she's here today
to tell us exactly why this is such an important topic.
And spoiler alert is
because the world isn't as big as we think.
It's
Hi, Alicia. Welcome to the podcast.
- Hey, Kai, it's so great to be with you.
- I'm so glad to have you.
And you know, it's World Health Day is being
celebrated on April 7th.
And you know, from what I've learned about you
through our times of hanging together
and becoming friends, uh,
I knew you did something really important.
You were often traveling, uh, to throughout the world, um,
in advocation of some sort of health related thing.
I wasn't really sure. And then, you know, I just kind
of asked you, Hey, would you be interested
to do this World Health Podcast with me?
And you're like, sure. And then you sent me over
a link to your organization.
And not only is your mission just incredible,
but you're the CEO of the organization.
So can you just tell me more about, you know,
what is your organization and the role you play in World
- Health?
Absolutely. Well, I'm so fodder
that you invited me to have this conversation.
I think, uh, universal health coverage
and access to healthcare is something
that really matters to me.
Mm-Hmm. , um, you know,
I think we've touched on,
but my journey is really one where
I grew up in North America.
I grew up just outside of Washington DC
and I think I was very fortunate I had regular access
to healthcare throughout the entirety of my life.
Um, as did my family.
And I had expected that I would actually study medicine.
I went to university
and, um, took all the course pre-reqs so
that I could become a doctor and Okay.
Wow. Yeah, and I, I think much to my father's chagrin,
I made the decision before starting medical school
to take a gap year.
Okay. Um, and in that gap year, I realized something,
I realized that the way in which we structure
how healthcare is accessed Yeah.
Um, many people are really suffering
and unable to access care.
Not necessarily because there are,
are inadequate clinical interventions, but
because the way that our health systems are structured Yeah.
Kind of really looks to reinforce marginalization. Sure.
So did a bit of a shift, um, yeah.
And actually shifted over
to really focus on public health with Oh, wow.
A particular focus on
how health services can be made available to people that
otherwise would go without access.
- And this, this started in like your local community
outside of dc like community health or?
- Yeah, it's a great question.
So, uh, actually in New York City, okay.
I kind of moved, moved to the big bad city from Colorado,
which is where I did my undergrad.
And, um, got a job doing direct service, uh,
in case management as a community health worker.
Okay. Uh, and as a community health worker,
what I was doing is I was actually going to folks' homes,
um, that were navigating different issues, be it sort of,
um, mental health challenges Mm-Hmm.
or substance, uh, use disorders. Yeah.
Or, you know, other non-communicable diseases like
hypertension or diabetes, or maybe folks were HIV positive.
Mm-Hmm. . Um, and a lot of what I saw was that
these folks both deserved access to care.
Right. And often the system was not structured in a way to,
um, meet them where they were.
Um, and I think the absence of the,
their, their ability to, to access the care
and the services that they deserved in a dignified way, um,
really, uh, changed my trajectory.
Yeah. Uh, in terms of what I pursued for,
for what I'm doing now.
- And, you know, it's a beautiful segue into
what this year's theme is for World Health Day.
It's my health, my right. Mm-Hmm. .
And it feels like you just are embodying that.
So can can you tell us what, what does that mean to you?
- Absolutely. So, you know, I think Kai,
we know one another now,
and the, the role that I currently sit in is actually
leading an organization by the name of Last Mile Health.
- Last Mile Health. I just
wanna make sure our listeners heard that, right? Yep.
- Last Mile Health. - Okay. Fantastic.
- And, and our focus really is on recognizing
that I is universal and access to care is not Mm-Hmm.
and figuring out ways in which we can go the
last mile to make sure
that every patient has access to the care that they deserve.
Um, to put some numbers behind this, we actually know
that today as we speak,
half the world's population lacks access to healthcare.
And about 2 billion people lack access to care simply due
to geographic distance.
So a lot of what I do and my incredibly capable colleagues
and sort of the community that I'm part of look at is
how do we ensure that the way
that health systems are designed, um, are inclusive
of integrated services, particularly for those that would
otherwise be out of reach of care.
And the approach we bring to that is really
around looking at the health workforce
and really looking at
how community based primary care can be better delivered.
- So, I mean, you said community based and,
but that's was exactly your experience in New York.
So like, is there a correlation there?
Like does it feel the same? Is it different?
- So I think that there are absolutely, uh,
clear correlations
and lessons that can be learned between North America,
Europe, Africa, Asia,
and when we think about delivery of care
to people in the community, actually
by community health workers, by professionalized members
of the community on the
- Ground to - Exactly
who like really get their community's needs,
who are often representative of the communities
that they serve, um, we know that that actually yields
to one, a path towards achieving universal health coverage,
especially in settings that might
otherwise be more economically disadvantaged.
Mm-Hmm. . Um, but it also
yields improved health outcomes.
Like we see tremendous increases in terms of access to
immunizations or maternal health care, um, you know,
proactive health screenings, um,
by community health workers and that matters.
- Yeah. Yeah. And so I guess focusing on that community,
so your mission is to make sure
that those community based programs are rich, vibrant,
and like as up to date as possible.
Would that be a good way to frame the work you do?
- It's a great way of thinking of it. Okay. Perfect.
I think that when we think about
what a exemplar community health system looks like, we know
that that health system needs
to have community health workers
that are operating at national scale, that are, uh,
integrated into systems of financing
and also how data is used and administered.
And those community health workers also need
to get the inputs that they need Yeah.
To do their jobs. So they need the skills, the supplies,
the supervision, and the salaries, um, to make sure
that they're able to show up every day
and deliver care to their neighbors.
- Ah, do you, do you feel like it's ever
like just insurmountable?
- I don't, um,
because the, the solutions
are proven and demonstrated.
Mm-Hmm. , you know, I, I look at a country like
Liberia in West Africa, um, where I've lived off and on
and worked for at this point a quarter of my life.
And Liberia is regularly ranked among one
of the most economically
disadvantaged countries in the world.
And what I can tell you is that Liberia is on track
to achieve universal health coverage by the end
of calendar year 2025.
- Oh my gosh. Are you serious? - 100%. So, go
- Ahead.
Well, I was just gonna say, I mean, if when, when you,
when you, I guess the, the stigma associated with, you know,
poor countries Mm-Hmm.
, you would just assume that the healthcare
is less adequate than our own.
- Yeah. I mean, there can be that presumption
and I think Mm-Hmm.
, what we've seen in Liberia is
that there has been a clear-eyed commitment, um,
by the government to bring on community health workers, um,
over 4,000 of them to date, uh, to serve a population
of a little under 5 million.
And those community health workers every day are present
going door to door to make sure
that kids are getting the care that they need,
that moms are being supported.
Yeah. That people are able to be healthier.
And to me, seeing that
and seeing it, you know, something
that would've been presumed impossible, actually,
like made possible, um, really is a lesson
that I think many other countries
can look to and learn from.
- Yeah. And I guess, you know, why do you think
that community-based program works?
And it might be a leading question. Mm-Hmm.
, because I think what I'm trying to get us
to is this idea of empathy.
Mm-Hmm. and like emotional intelligence.
Mm-Hmm. is, do you,
do you feel like those are some of the traits that are
with a community health worker
that translates into better healthcare?
- 100%. I think the ability to be present, to relate, to
understand the social determinants in the context
that a individual or a family is navigating matter, um,
and the ability to deliver services, um,
healthcare is one of 'em.
Um, context matters. Yeah.
And, you know, I think that we are regularly seeing that
mom's willingness to listen to advice for their kid,
or their ability to even just physically access the
treatment for malaria that their child so deserves
that is made possible
because of community led primary care
and community health workers. Wow.
- It's such a beautiful mission
and it just kind of brings along this idea that
how connected the world actually is.
Um, and I feel like we really felt that during covid.
- I think you said it so Well. You know, I, I think that
what Covid really reinforced is that there
is no them, there's only us and Mm-Hmm.
the interconnectivity of
truly global health at this point.
It means that, you know, I, I lived
and worked in Liberia
and West Africa during the 2014, 2015 Ebola outbreak,
which I think was a very scary time.
And what we saw was that a 2-year-old child
in the rainforest of Guinea fell ill with fever, vomiting,
and pretty shortly thereafter,
that child's aunties fell ill.
And then before we knew it Mm-Hmm.
, we actually had an Ebola outbreak
that spread across West Africa,
but also where we saw people getting sick,
like in our very own New York City.
Yeah. Um,
and I think Covid really reinforced the fact
that illness is universal.
Access to care is not Mm-Hmm. .
And some of the best approach in terms
of pandemic prevention
and detection is by making sure that there are well-equipped
supported community health workers
in each and every community.
- Yeah. Because I think what you hear now, it's not a matter
of if, but when it happens again,
- You're spot on there. Yes.
- And I, I just, I don't know, just personally
as your friend, it,
it feels like this is a really heavy, heavy job.
Or maybe you can help me better understand like, what's,
what's the emotional weight you carry
and like, how do you maintain work-life balance?
'cause that, that's what we do at balancing life's issues.
We try to make sure an employee, a manager, A CEO is
taking care of themselves as well.
Right. Because ideally you pour yourself into your work
and it's a lifelong mission,
but you can get wrapped up in that, you know, how
how do you maintain a sense of self with,
with all this going on on around you.
- You know, I think working in mission driven
work is a privilege.
Um, and you're right that it's something where so much
of our identity
and our sense of purpose can get tied up in
that mission driven work.
I think something I've come to learn is
that there are really three things that matter
to me in my professional endeavors.
Um, one is being able
to work on things that are values aligned.
And in my core, I truly believe
that nobody should be left out.
So working on something
that is really focused on inclusive access
to healthcare fuels me. Yeah.
- Think it gets you up in the morning.
If it was a really hard day, you know,
you can get up tomorrow because that value is aligned
- One 100%.
And I think, you know, the point you just made, Kai also
around like working on things that are hard.
Um, you know, we we're doing this work, not, not
because it's easy, but because it is hard.
Mm. If these, if these were challenges
that people had already addressed, there would be no need
to wake up every day
and to tackle these things that are difficult.
It's hard to work in remote areas, it's hard to work Right.
In communities that have often been neglected,
it can be hard to work with government partners.
Um, and still it's really important.
And that kind of brings me to the third thing
that I regularly focus on and that I think is so critical.
And for me, and I think for so many that do this type
of mission oriented work is the
community that you're part of.
And I, you know, stand in service with a team of,
you know, over 200 health professionals
that are getting up every single day
because they believe that people have access to, to, uh,
should have access to care.
Mm-Hmm. and more broadly, we're part
of a broader and growing ecosystem of people that believe
and know that healthcare is a human right.
And that we have it within our power
to, to realize that vision. Yeah.
- Yeah. I'm, I'm so glad you ended with community
because, you know, it's one of the five buckets
that over here at BLI that we, that we empower people
to put some water into every once in a while.
Like, the importance of your community and,
and the fact that I just ended up meeting you
through some friends down at a brewery
around the corner is just kind of speaks to this,
this whole idea of community and what, what fuels you up
and keeps you energized.
And I think the last thing I wanted to ask you,
'cause I know your time is extremely valuable, um, is
this can all feel so removed from Mm-Hmm.
the self, like, for me, like, I'm imagining
like world health, like, it's insurmountable.
It's huge. And I think for a lot of listeners,
it's probably a similar feeling.
Um, however, like what's,
what do you feel is like one thing someone like myself
could do to be more engaged in world health
or to be a better advocate for it?
- Well, the types of solutions
that we're looking at in the majority world,
or, you know, in Asia and Africa are equally relevant here.
You know, just outside of New York City.
Um, the notion
that community led community driven primary care is the path
that is going to help us achieve universal health
coverage is no longer a debate.
It's just a truism.
And I often reflect upon the idea of like, pray
for peace, work for justice.
And the path for each
and every one of us, I think really can be, um,
thinking about ways in which communities
that maybe had previously not had a voice
or that had been excluded from services be
that healthcare otherwise.
Right. Like education. Yeah.
So, so much of the work that you're doing is
so important in terms
of whose voices are represented in these conversations
related to work life balance.
Yeah. Um, defining paths to make sure that those that
otherwise might not be invited to the table
or invited to the healthcare screening are,
I think is a really admirable
and important way for all of us to play in a part in,
you know, building a healthy future.
Yeah. That, you know, we all wanna be part of.
- Yeah. No, it's, it's so well said.
And I think maybe what I heard in there was, you know,
pay attention to health rights this year and,
and vote in, in that direction of, of health.
Right. And advocate for health rights for all.
Um, and Lecia, I can't thank you enough for being here.
I know you're in between moving
and traveling and all of this.
So thank you so much for your time and energy.
It's, it's been wonderful to have you.
- Hi. It's been such a joy.
Thank you so much for inviting me and for being a friend.
- Of course. Until next time, everyone, take care.
This has been a production of Balancing Life's Issues
with your hosts, Kai Sorenson
and Wendy Wallner, produced by me Kai Rate.
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Miles.