Embracing Future Tech and AI for Better Health | Making Public Health Personal Podcast Ep21
Public health really looks at people's situation and not just health, but from economic and social and behavioral aspects. And it's one of these things where you can't ignore it, because it affects you in so many different ways. Every day you're thinking about how are your surroundings actually affecting your health and not just like physical health but mental health emotional health. And so when I was growing up, I didn't necessarily have the means that other people had. So you quickly learned that your surroundings really affect what you do. And that's why I became very interested in public health. That was today's guest, Bruce Y. Lee. Hello and welcome everyone to Making Public Health
Personal. This podcast is brought to you by the CUNY Graduate School of Public Health and Health Policy in New York City. I'm your host, Laura Meoli-Ferrigon. Thanks for listening. Today's guest is Bruce Y. Lee, Professor of Health Policy and Management at CUNY SPH, where he is the Executive Director of the Center for Advanced Technology and Communication and Health, otherwise known as CATCH, and the Artificial Intelligence Modeling and Informatics for Nutrition Guidance and Systems Center, otherwise known as AIMINGS, which is supported by the National Institutes of Health and serves as the AI Center for the NIH's Nutrition for Precision Health Consortium. Bruce
is a systems modeler, professor, writer, journalist, an expert in computational and digital health and artificial intelligence. He has authored over 255 scientific publications focused on developing and using new systems, computational and AI modeling methods. Dr. Lee writes extensively for the general media, including the New York Times, HuffPost, Time, and The Guardian, among many others. He is a senior contributor for Forbes, has a blog for Psychology Today, and his work and expertise has been featured on television, radio, and other forms of media. In today's episode, we'll discuss the benefits and disadvantages of advanced technology and AI in public health, and how to embrace technology for a better future. We'll also discuss current trends and the future of communication and education. Bruce, thanks for joining me.
Thanks for having me, Laura. We recently sat down for a video interview that we did about CATCH (the center for advanced technology and communication in health). And what I found interesting about our chat is how your center merges technology and communication. They really are very much interwoven today with social media as an important part of information sharing. Could
you tell our listeners about CATCH and the great work that you and your team is doing? Yeah, thanks Laura for the opportunity to talk about CATCH and our team. if we think about it. One of the big things that technology can do is it can help with communications and can help with decision making ultimately too. And when it comes to health and public health, it's all about decision making. You have to make different types of decisions, either at the policy/governmental level or different companies and organizations have to make decisions. People have to make decisions about themselves and about their loved ones,
about their families, about their coworkers and colleagues. And, you know, we were really moving into an opportunity to transform a lot of that decision making. So if you look at a lot of other sectors and a lot of fields Previously, before technology helped advance those fields, you know, decisions were made sometimes haphazardly. So many times I give the example of meteorology. So, most of us weren't around before you had weather maps and simulation maps and those things like that. So how did people make decisions? You know, you might step outside and you say, okay the cow's
lying a certain way. And I see some clouds in the distance. So maybe it's going to rain. And then maybe you could predict the weather in potentially an hour or so. But beyond that, you didn't know what to do. But nowadays we take it for granted. We have all this technology that helps us really understand what's happening with the weather, with the cloud formations, wind, with the barometric pressure, all these different things. And then we can actually get a pretty good idea of what's
going to be happening, not just over the next 24 hours, but next week or month. We know that it's going to be a particular warmer or colder winter or things like that. So it's really transformed decision making and we really have opportunities to do that in health and public health as well.
So definitely, as you said, technology evolved in our lifetime and it continues to move at such a rapid pace. It's kind of hard to keep up sometimes. Can you describe some new advanced technology and artificial intelligence as it relates to public health? That's funny. So when I first started with my research career and work, et cetera I was very interested in how computers can help decision making. And I remember back then I'd use some
of these terms and when people would look at me I had three heads because they're like computers, what is this stuff, et cetera. So it's been interesting seeing the evolution over time. You mentioned AI, you know, a couple of decades ago, people will be like, are you talking about Allen Iverson or what did this AI stuff, but now it's become very vogue to mention the word, but what do we mean by AI? So it's short for artificial intelligence, and it's actually a very broad term. So it encompasses any situation where you're using computers to essentially mimic what the brain normally does. So if you think about the brain does many different things, the brain takes information , it analyzes, it interprets it, makes decisions, it assesses things, So anytime you get a computer Or computer technology to do that kind of stuff, it's considered AI. And the
difference is in the past, we would basically tell computers specifically, you know, do this, then do this. Like the computer was almost just like a completely obedient servant, so to speak. The computer wouldn't really think on its own, but now we're at a point where we can put in algorithms so that the computer can quote unquote think the computer can fill in some of those blanks and move to the next step without you specifically saying that. You know, I want you to produce this number. I want you to do this. And that's the difference with AI. And that incorporates a lot of different things. So it incorporates getting computers to analyze information and turn out recommendations you know, computers to help decision making. Now
we're seeing computers be able to write things, produce art, produce songs, things which are more advanced. And I think some of the latest stuff has really captured people's attention. Like it's been a steady progress over the past couple of decades where computers have gotten better and better, but once like computers can start “talking to you” or start “singing songs to you”, then you're like, “Oh, wow, this sounds like a real person”. So I think that's why it's really caught a lot of attention. Especially, you know, with chat GPT and things like that in recent times. But it's now becoming more and more accessible to the general public. I think people are excited about that. Yeah, and definitely people who are in higher ed are familiar with chat GPT, Bard, other AI tools, and a big discussion and fear is about how students are using these tools for plagiarism. I think, as an instructional designer,
I think it's a good challenge for professors to have to think outside of the box with their assessments.Not everything has to be a paper or writing assignments, but what are your thoughts about the current trends and future of communication and education? I think one of the key things that we have to remember is technology is neither good nor bad. So there are some people who are like, “Oh, all types of technology is great. As long as we're advancing”. That's not really true. And then there are people who are like, “technology is awful. We should, not adopt these things because they're dangerous”. And the truth lies in between. It
really depends on how you actually use things. If you think about it, anything, you know, if you use a pillow to sleep on, that's good. If you use a pillow to you know, hit a lamp, then it's bad. Right? So, so similar with technology. And one of the things that we need to do is, as we develop these different types of technology, we also have to think about how are we going to use these things for good. And that's one of the things that we do in CATCH, not only do we develop this technology, but we also use it, but we also kind of raise the discussion of how should technology be used? What kind of safeguards should be put in place? So the big opportunity with AI is it can do things that help humans free up their time to do more things, right? So if you think about it. You look around, there's a lot of things
that technology does that we used to have to do so like a laundry machine/washing maching. A vacuum. Yeah, vacuum. You have to kind of vacuum around. You know, it's great you can take some of these things that used to consume our time and, you know, may not contribute to our well-being. Although some could argue if you like clean really aggressively, it helps your physical activity.
But then it frees up our time. And time is that one commodity that we can't replace, right? So, it frees up our time as well as our brain power to elevate ourselves in society. So spend more time to kind of focus on other things. That's where technology can really help. So, for instance, if AI can help with decision making, like if AI can provide, “Oh, did you think about this?” Or, you know, “we've looked at these complex processes and analyzed them. And here are the results”. Let's see how this can help decision making. That's where AI can really help. So we want to
identify those things on the flip side. It can hurt when it is being used to replace things which are innately human, are inherently human. One of the things that can get people nervous is you know, I remember there's a headlines what was a couple months ago or so, there was some study that claimed, “oh AI can show more empathy than doctors”. And so, but if you look at the study, it's yeah, sure, AI can use some of those terms and those things like that. That's a big jump, right? You don't want to sit here and say, yeah, I'd rather have this AI talking to me than the real doctor. And we do know that there's a whole range of how empathetic doctors may be. And you
know, you want someone who's a lot more empathetic as opposed to someone who isn't. But ultimately you don't want to sit here and replace a human being. In that type of situation. And similarly, you mentioned like creative endeavors. Sure, chat GPT can come up with a, interesting song
or maybe some kind of like creative, right? But it's not the same as a human actually come up with these things. So those are things that we don't want to replace. We can enhance, like we can have, AI provide ideas or things to spark, but not replace. We don't want to replace. Yeah. Something I've been seeing in the news lately is these self-driving cars and how they're rolling that out in certain cities. And I think about how driving requires so
many decisions and, in a scary situation, do we want computers to be worrying? Do we hit this kid or do we go this way? Do we want to leave that up to a computer? Yeah, that's a weird situation, right? Because we already have public transit right where people can, you know, you don't have to think about it, you can sit down and then you can do work or listen to something, and the train is doing the work. And that's the advantage of public transit. Another advantage is that you're, you know, you're mixing with people and things like that. But then you've got cars where people say, Okay I'm going to drive it myself. And that's the whole purpose of a car. So that, you know, you feel you have control over, but then if you're moving to autonomous cars isn't that like public transit, but without people mixing with each other.So we have to ask ourselves. what is the, what are the benefits and disadvantages of moving towards different directions rather than blindly saying, let's move towards this and accept everything will be okay. So we really have to think about these. I'm not saying that autonomous
driving self-driving cars are necessarily bad. And there might be a need for those things, but we have to think about what the secondary tertiary consequences are and the unintended consequences. We've run into so many situations in the past where we've had unintended consequences with well-meaning technology, etc. So, you know, one example is social media, right? So social media became popular at the very beginning because people said, hey, you know, you can connect with someone like your high school friends, someone you know, and you haven't seen this person in years.
Then what, look, we're actually communicating or look, I found my prom date or things like that. Right. So that's great. But then there are also negative consequences of social media, and that doesn't mean social media in general is bad, but as society, we didn't think about. How do we put in safeguards to prevent the negative effects? Right. We only deal it with after we're like, Oh
my goodness, what happened? You know, people are feeling more lonely with social media or feeling more disconnected or this, all this misinformation that's being spread. These conversations were not being had you know, in the early 2000s when social media was starting to really pick up steam. Yeah, I don't think they knew they were going to use social media for news distribution. And so a lot of misinformation, disinformation comes from social media. And I don't think that was the intention. Absolutely. Yeah. And then the trouble is the discussions weren't even being had,
right? So people weren't even thinking about it and say, Hey, Oh, look at all the holiday presents under the tree and just opening it up without really kind of thinking about what does this actually mean and what should we actually do with this? And what should we be careful about? AD: If you dream of making a difference in the world, a public health degree or certificate can give you the tools to do just that. The City University of New York's Graduate School of Public Health and Health Policy equips public health professionals to advance not only a healthier New York city, but a healthier world for us all. We want you to join us in our mission. Visit sph.cuny.edu to learn more about our program. No matter where you are in your career, CUNY SPH offers a broad range of degree and certificate programs to not only help you advance in your career, but to have a real impact on the world. Public health professionals are needed now at more than ever. Join us visit sph.cuny.edu to learn more. And so how is misinformation and disinformation on social media harming public health? Yeah. So if you go on social media, you only have to spend, a few minutes on social media
before you start encountering misinformation and disinformation. And the difference between misinformation, disinformation, I'm asked these many times is misinformation is information that's wrong. It doesn't imply intent though. So people might share information that's incorrect, but they're not deliberately trying to mislead people. Disinformation is when you're actually
trying to deliberately mislead people. we have to remember there's a lot of that on social media. It's not sharing stuff that might be erroneous. There's people there saying that I want to spread this false information for a political agenda or for a financial agenda or because I would just want to create chaos or just because this is how I have fun. So it's almost like you are getting on social media and you are having active advertising that's trying to get you to think a certain way. And it's incredibly prevalent on social media. And there's so many situations
where people regularly will share things with me and is this true? Is this correct? And many times I'll write about it and for Forbes and there's no shortage of materials, right? Ranging from people saying that, a vaccine will turn you into a gigantic magnet or like a refrigerator door where everything will start sticking to you. You know, there are people who believe that. Yeah. And so do you think that there's any remedy for this? I mean, aside from regulating social media, how do we get people informed about public health in a safe way? So I think there's several ways. You know, naturally misinformation will always be out there. It's been out there for centuries. And continue to be out there. So it's falling to think that, oh, it will stop. That everyone will always push out proper information. So instead, what we need to do is several things. So one is be more creative about communicating public health knowledge and
information. One of the challenges has been that there has been a lot of very old school ways of communicating about public health. And sure, a lot of those things are good but it's not really changing with the times. And I've heard the argument, people saying you know, public health and health information is complex. But I give the example of if you jump on YouTube and you search
for like Avengers trailers or things like that, you'll find videos. Sometimes they're like 10, 15, sometimes half an hour, where people are analyzing an Avengers trailer ad nauseum. They're sitting there and saying, Ah, you know, when Tony Stark did that, this must mean this thing. Or, you know, Thanos, you know, is looking, you know, this. Oh, look, there's an Easter egg back there. So, that tells you that people are interested and willing to try to embrace complexity. They want to analyze it. They want to think about these things. So why not do that with health or public
health? Right. But the difference is people feel it's fun to look at an Avengers trailer, right? They're being entertained. It's flashy and you know, you've got personality and all those things like that. Why can't you do the same thing with public health? You know, tickle people's brains in other way. I think one of the challenge with public health is there's been a lot of you know, doom and gloom or scare people like don't do this, but why not make it fun. Why don't make it funny,
you know, entertaining and those things like that. So I think we need to take new approaches. And so I know, Laura, you yourself are taking new approaches in terms of communication, which is great, which is fantastic. And so think about new ways to do that. The other thing is we need to think about expanding the audience and moving things earlier. So, kids, why not expose them to public health? A lot earlier at the beginning. if you were to ask a lot of kids about public health, they may not even know what public health is, right? True.
Help encourage that. And also the focus of public health communication shouldn't just be health professional or government officials. It should be people of all sectors, like we need to tell everyone, you know, you're an artist or you're in, you know, the manufacturing sector or you're in the finance sector, public health actually matters to you as well. And here's why it matters and then we need to stop using all that kind of jargon that no one else understands.
Medical jargon. Yeah. Agreed. So among your many areas of expertise is precision nutrition. So what exactly is that? I know before we were talking about using technology to improve our lives, but precision nutrition seems right on, on track with that. Yeah, so the word precision became in vogue, you know, over the past 10 years or so. So there's like precision medicine, precision health, the concept of precision is making things more tailored to how people differ, right? So one of the challenges with health and public health in the past is there's been a lot of one size fits all solutions. You know, everyone should do X, Y, and Z, and sure, there's certain things that everyone should do okay, don't eat dirt, is probably something that people should, no one should eat dirt, although you'll get an argument with almost everything, but, okay, but then there's, beyond that, there are more specifics, because you know, people are very different. There's incredible diversity among people. And I don't mean diversity between different, like social demographics and stuff like that.
That type of diversity actually many times is; those differences, many times are overemphasized. People are individuals. So they're different, so many different ways. They differ in their personalities. They differ in their behaviors. They differ in their surroundings, their social
connections. People's biologies differ. Their economic statuses differ and those things like that. Okay. So then if you look at something like, for instance, clothes. We don't tell people you should all wear the same clothes, right? We don't do that. There's tremendous variety. So why do that with different health measures and why do that with nutrition? So one size fits all doesn't work with nutrition because if we look at a lot of like dietary guidelines and nutrition recommendations many times it's like for the entire population or you have people pushing diets like Everyone should be on this diet Everyone should be on the all cauliflower, but nothing but cauliflower diet, right? But that's just not the case. There's no magical diet for every single person. So precision nutrition is about better tailoring nutrition guidelines, dietary recommendations, all those things to the differences in people. So one of the key things
is trying to figure out how these differences then manifest and affect both nutrition and the connection between nutrition and health. And that's what precision nutrition is. And I know that there are a ton of apps nowadays for nutrition, for health, you know, that's tracking our heart rate, our sleep, our food, what we're eating. All these different aspects of our health. Should we be afraid to share that much information with, you know, Google or these different companies or how can we use it in a positive way? Yeah. So there's a couple of things with that. Many times when you get these apps, you don't
know what's really behind them. You don't know how they're actually churning out the recommendations. And so we have to be careful about that, right? These are the so-called black box apps where they give you maybe some sense of what they're doing, but you don't know what's coming out. So this is an example where AI technology can potentially do harm because there might be biases built into that, right? That might be based on data from one population that doesn't really apply to you. So
one of the things that we want to encourage is when you get those apps, you need to know what's behind the apps, right? Just if you think about it, if someone were to give you advice without knowing anything about your life, give you for instance, like relationship advice without even knowing anything about you, you would sit there and say, you don't know anything about me. It's the same thing with the apps. Like where are you actually coming up with those things? So I would say, first of all know that. Second of all with, yeah, with the data issue you want to be careful about. Who you're sharing your information with it's so interesting because if you take a lot
of that information, you tell people, would you shout out that information to everyone and say, “Hey, everyone, by the way, this is what my body's like, My BMI and my weight. All these things.” And most people would say, no, I'm not going to do that. Or would you just go to work and say, “attention, everyone, attention, everyone. I want to tell everyone about details about my body”, right? Please listen. You people, most people would say some people might do that, but most
people would say, oh, you know, I'm not going to do that. That's, but yet you're going to put all this stuff into an app that you don't know where that goes. Right. So you want to be careful about that. I think one of the challenges with these app is, it's sitting on your phone. So it looks like it's your private buddy and you know, that, that buddy is like, “shh, don't tell anyone”. But it's not the case. You need to look carefully at how that data is actually being used. And then you
have to be, you know, actually comfortable with that. But there's many times not enough of that. Yeah. Is it a matter of reading that really long user agreement that we all click agree on? Yeah, here's the 50 page thing in three point font. Now click agree. And the trouble is when you download the app, you're so anxious to use the app. You're like, I want to check out this app. You're like, yeah, I agree. But you have to remember like, you know, what are they saying there? You know, we can use your like this in any commercial or something like that. You don't have no idea what is written there.
Absolutely. So let's chat about virtual reality and public health. And I remember back in 2019, right before the pandemic, VR was really taking off and it still is, but the pandemic seemed to shut down a lot of the gaming and leisure facilities that we had for VR. There used to be a lot of these kind of arcade places that I used to go to. Is virtual reality still being used in public health? And can we expect to see more of it or will augmented reality or AR be more of the direction that we can expect that type of technology to take? Yeah, I think it's one of these things where we are really only scratching the surface when it comes to VR and AR. There's been some use of it, but the potential is much greater than the
use that has occurred. As a similar situation, there hasn't been as much thought put in the matter. Like, how can we use this actually for good, positive way as opposed to a neutral or negative way. So the answer is yes, it's going to increase both VR and AR. But the question is, are we actually prepared to fully leverage these technologies in a positive way? You hear talk about these types of approaches replacing humans. You know, you can go and talk to the
virtual doctor or something like that. We have to be careful about that. This can go different directions, but one of the potential bad directions of technology like this is, you know, you can see like organizations or companies say, “oh, we can really cut costs by cutting out people”. You know, we don't have to have employees. We can have this technology doing this. Why not have a virtual health professional that can do these things rather than a person. But that overlooks a lot of the things that you get from a real-life person. The real-life person
is not just his or her knowledge. It's not just that person's technical ability. It's also that person's judgment and that person's compassion, that person's empathy, that person's experience, that person's connection with you. Even the actual connection itself can be valuable, right? Very valuable. So we just have to be careful about these things. So what types of technological advances can we expect to see in the future? Well, certainly one thing is making information flow more freely and make it more available. So if you look in public health I remember walking into a county health department maybe this was around like 2008/2009. And you walk in, okay, and there's a fax machine on the left there was
a rotary phone in the health department. You look at some of the information and they're on these like yellowing pieces of paper and there's this file cabinet. And then there's this one person there who was the bank of information. You worry like if that person ever left or retired, then suddenly all this information would go away. Now, I mean, I think there's been some advances in like health departments since then. And that's just one example. It was actually a fairly large county health department, a metropolitan county health department, but that was the case, you know, back in 2009. So, there has been some advances, but there's still a lot more opportunity
to make all this information more, not only just cataloged, but more accessible and we can use this information in different ways. So that's one big area where you can really have huge jumps in how information is available to all kinds of different people. We saw during this COVID 19 pandemic where there was a lack of information. There was a lack of communication and we did see some of these with these websites where you can kind of look up things. But that can jump significantly, right, where people can really kind of look at this information, do analyses with this information. So that's one big area, you know, how are we actually sharing information? Another, of course is decision making. You know, one of the things that we do as part of our center is
we build these computer simulations. So we'll simulate different things. So it's. that we've used from the start. It was like, this is the Sim City of public health so you can actually simulate these things similar to how people simulate a mission, like a rocket mission, launch a rocket into space. That's done after not just millions, not just billions, but trillions of hours of computer simulation. They'll simulate everything and they'll adjust
what's actually going on. So they will be able to anticipate what's going on. So we should be able to do that in public health, right? So why not do that in public health? There are certainly opportunities for you know, virtual assistants, virtual decision makers, those things like that. And also there's opportunity of people being able to experience things in public health using like virtual and augmented reality. So they can better understand other people's perspectives. That's just scratching the surface. There are all these different types of things. There's a lot of things that we can do in terms of media, mass media communications, different types of movies and videos and things like that. And they can be augmented with technology. There's CGI
that can help with a lot of different things. So yeah, that's just scratching the surface. So, how can we embrace technology for a better future? We have to keep in mind. That when we use technology, we want to advance all of society. I want to emphasize all of society. The big risk when you have technology is it benefits certain
people leaves a lot of people behind. It can actually technology can either worsen things like disparities. It can worsen conditions for certain people. It can create more separation or on the flip side, it can do the opposite. It can bring people together. It can reduce disparities. It can bring more equity. It can enhance diversity, all these things like that.
We really want to be in that situation. Right? So, so how do we avoid the former situation? How do we harness and leverage technology to actually bring people to get in those things? First of all, we have to think about is technology actually representing just a small segment of people or is it representing everyone? And that includes like the underlying data. So let's say for instance you had some type of app that turned on, say you need to always eat organic, fresh produce. That's your solution. And you also need to get a masseuse every day and get a chef. I love these ideas. And people are like, great. Okay. So that will be fine. If you are in Silicon Valley and you have a
big house or something like that, or that'll be fine if you're like Beverly Hills etc. But for most people or many people, that's very difficult to, and for a lot of people, that's impossible, right? Because you've got people sitting there and say, look, I'm just trying to survive. Right. And I don't have a organic grocery anywhere around me. Right. You know, I basically have a donut shop and that's it. So I can't follow these recommendations. So therefore, that is useless
for most of society. And it will actually worsen disparities, right? Because if people are advised to do that, they're like, I can't listen to this. I'm just going to go eat donuts. So, we have to make things practical for everyone. We have to use the data that represents all of society. We have to understand the differences among people. We have to create technologies that account for these
differences, account for these complex systems that affect what people do and therefore come up with really things that are appropriate. We've already seen that public health, right? People come up with public health recommendations that don't account for differences in people's living situations, their cultures, all these different types of things. So we really need to make sure that the underlying data, the construction of technology matches the true diversity that's out there. Secondly, we need to think about how technology can actually bring people together rather than divide people. Right? So, social media. Yeah. In some ways brought people together, but it's also dividing people. how do we help people better empathize with each other's
conditions? You know, one of the key things that I think we have to keep in mind when we talk about things like diversity and inclusion equity and those things like that. And we talk about things like, Oh, it's something that's good to do. No, if you want to be completely utilitarian about it, it's actually best thing to do for everyone, right? Because there's so many studies that have shown, for instance, biological diversity, actually species that have more diversity actually are stronger and become more dominant because they have like diversity of ideas and backgrounds and those things like that. So you actually learn more when you encounter people who are different and when you approach a problem, we have different perspectives. You can
solve the problem in a better way. Or if you have different people doing different things in society, the society benefits. So we have to think about that. We have to think about those things aren't just catchwords. They actually benefit society. So how can we use technology to actually enhance those things so that we could actually have a better society for everyone? We've actually demonstrated with some of our models how for instance, if you actually account for lower income neighborhoods and make sure they're healthier, it actually benefits everyone else. So, those are ways that technology can be used in a very positive way. And so we really hope that it
moves that direction and we have to keep that conversation going so that people realize that technology doesn't automatically have to leave people behind. Oh, The last thing you have to make technology accessible, right? People actually have to be able to use it. So how do we make technology available to people of all income levels, people of all backgrounds, and those things like that. Thanks again, Bruce, for being a guest, and thanks for listening to Making Public Health Personal, presented by the CUNY Graduate School of Public Health and Health Policy in New York City. You can now share, like, and subscribe to our show anywhere podcasts are heard and on our YouTube channel. To find out more about our school, you can visit sph.cuny.edu or connect with us on social media. This is your host Laura Meoli-Ferrigon signing off.
And while public health has a global impact, that doesn't mean we can't make it personal.