- The Huberman Lab Podcast features discussions on science and science-based tools for everyday life.
- The guest on this episode is Dr. Vivek Murthy, the acting Surgeon General of the United States.
- Dr. Murthy oversees public health officers who protect and promote public health.
- The discussion covers topics such as nutrition, obesity, food additives, mental health, loneliness, and corporate interests in public health.
- The episode aims to educate listeners about public health directives and the challenges faced by the Surgeon General.
- The podcast is sponsored by Maui Nui Venison and Roka.

- The focus on mental health should go beyond preventing diagnosable mental illness and also aim to optimize mental health and well-being.
- The Surgeon General believes that the healthcare system should prioritize prevention and enhancing well-being, rather than solely focusing on treating illness.
- Decision-making in the office of the Surgeon General is collaborative, involving other colleagues in the Department of Health and Human Services, FEMA, and states.
- The Surgeon General's office prioritizes issues based on data and input from the public, with a focus on the greatest need and impact.
- Examples of past initiatives include addressing the opioid crisis and e-cigarette use among youth.
- The Surgeon General also emphasizes the importance of listening to communities and hearing their concerns, which led to a focus on the issue of loneliness and isolation.

- The speaker discusses the importance of effective communication during crises and the need for clear and comprehensive health messages.
- They mention the lack of widespread messaging during the pandemic about maintaining circadian rhythm and its impact on mental health.
- Traditional media and online channels are currently used to disseminate health messages, but it is a patchwork system.
- The speaker suggests the need for a quick and efficient way to reach everyone in the country with health information.
- The historical focus on treatment strategies over prevention and health communication is highlighted as a challenge.
- The speaker emphasizes the importance of addressing factors such as sleep disruptions, circadian rhythm, physical activity, nutrition, and social isolation to prevent a mountain of health issues.

- The speaker believes that people should have access to accurate information about health issues like medication and dietary changes through reliable channels.
- They express concern about the lack of resources to address important health issues and the need for education on core pillars of a healthy life.
- The speaker discusses the importance of mental health and self-inquiry practices.
- They mention a sponsorship for a nutrition drink called AG1 and recommend it as a supplement.
- The speaker acknowledges the audience's engagement and thanks them for their support.
- They address a question about food additives and preservatives, expressing concern about the unhealthy composition of the American diet and the lack of access to fresh produce in low-income neighborhoods.
- The speaker discusses the availability of unhealthy foods in convenience stores and the impact of processed foods on brain circuits and appetite.

- The brain changes in response to highly processed or moderately processed foods
- Waiting for randomized clinical trials before taking action on the health impacts of processed foods may lead to a 30-year health crisis
- There needs to be more accessible information and resources for people to make healthier food choices
- Concerns about additives and synthetic additives in food without long-term data on health risks
- Food companies may prioritize selling more products over promoting health
- The impact of highly processed foods on the brain and overall health is a serious concern
- Objective scientific authority is needed to provide information on diet and food choices
- Authorities should be insulated from political retribution to effectively address these issues
- Making better choices and avoiding unhealthy foods can have significant impacts on health
- The brain can be rewired to prefer unhealthy foods over time
- Intervention is necessary to prevent future health challenges
- Knowledge about the nutritious value of foods can lead to healthier eating habits

- The understanding that nutritious food is beneficial leads to changes in ghrelin secretion and overall well-being on a healthier diet.
- The importance of thorough vetting and research before making statements in the field of public health to maintain trust and credibility.
- The challenges faced in speaking out about certain issues, such as diet and tobacco, due to pushback from industries with vested interests.
- The need for integrity and the willingness to face consequences in order to serve the public and rebuild trust in institutions.
- The impact of pushback from companies and the importance of mitigating their influence.
- The focus on science and the public interest in decision-making, even if it is politically inconvenient or jeopardizes one's job.
- The problems with the current food industry setup, such as making unhealthy foods cheap and healthy foods expensive, and the need to empower the public with information to make better dietary choices.

- The speaker drinks Element first thing in the morning to hydrate and replenish electrolytes.
- They also drink Element during physical training and after using the sauna.
- They provide a link to claim a free Element sample pack.
- The speaker discusses the issue of trust in public health messaging, particularly regarding mask recommendations during the pandemic.
- They suggest that the flip-flopping of messaging without acknowledgment of mistakes led to distrust.
- The speaker believes that public health officials should be transparent about what they know and what they don't know, and explain the reasoning behind recommendations.
- They acknowledge the challenge of delivering nuanced information and the importance of humility in approaching patients and the public.
- The speaker mentions the abuse and attacks that public health officials faced during the pandemic, leading some to leave their positions.
- They emphasize the need for an environment of humility and civility, where different views are respected and violence is not encouraged.
- The speaker gives an example of the mask debate and suggests that understanding and respect for different perspectives is necessary.
- They believe that failure to have open and respectful conversations contributed to division and a sense of "us against them."

- The Huberman Lab Podcast features discussions on science and science-based tools for everyday life.
- Dr. Vivek Murthy, the acting Surgeon General of the United States, is a guest on this episode.
- The discussion covers topics such as nutrition, obesity, mental health, loneliness, and corporate interests in public health.
- The Surgeon General emphasizes the importance of prevention and enhancing well-being in the healthcare system.
- Decision-making in the Surgeon General's office is collaborative and prioritizes issues based on data and public input.
- Past initiatives include addressing the opioid crisis and e-cigarette use among youth.
- Effective communication and clear health messages are important during crises.
- The lack of widespread messaging about maintaining circadian rhythm during the pandemic is mentioned.
- There is a need for a quick and efficient way to reach everyone in the country with health information.
- The speaker highlights the historical focus on treatment over prevention and the importance of addressing factors like sleep disruptions, physical activity, and nutrition.
- Access to accurate health information and education on core pillars of a healthy life is needed.
- Mental health and self-inquiry practices are discussed.
- Concerns about food additives, processed foods, and their impact on health are raised.
- Objective scientific authority is needed to provide information on diet and food choices.
- The challenges of speaking out about certain issues due to pushback from industries with vested interests are mentioned.
- Trust in public health messaging, transparency, and respect for different perspectives are important.

- Lack of open, honest, and respectful conversation during the pandemic hindered the response and contributed to division and polarization.
- Building trust, effective communication, and staying united as a country in the face of adversity are crucial for future pandemics and national security.
- Efforts are being made to acknowledge and understand people who feel harmed by vaccines, and data analysis is important in determining causation.
- Contextualizing vaccine side effects with other medications and clear communication is necessary to address concerns.
- Committees with diverse backgrounds and voices are suggested to provide a more relatable and vetted message to the public.

- The speaker discusses the importance of building a diverse community core to disseminate public health messages during COVID-19.
- They emphasize the need for different voices and perspectives in delivering these messages to different communities.
- The speaker suggests that media networks should feature more diverse faces and voices to increase trust and representation.
- Funding for community organizations that are on the ground and have trust within their communities is crucial for effective public health messaging.
- The speaker addresses concerns about the relationship between big pharma, government, and public health initiatives, highlighting the need for independence and transparency in medical advice.
- They acknowledge the influence of incentives and the importance of evidence-based decision-making in prescribing medications.

- The speaker believes that public health decisions should not be influenced by pharmaceutical money.
- Their office does not accept money from any industry, only taxpayer money allocated by Congress.
- The speaker believes that society has become reliant on medication as a quick fix for every problem, neglecting the importance of behavioral and environmental changes for health.
- They propose the idea of small committees with diverse expertise to provide holistic care for patients.
- The current medical model of individual appointments and referrals is inefficient and burdensome for both patients and clinicians.
- The speaker suggests that the business model of medicine needs to shift towards value-based care to prioritize efficient and integrated multidisciplinary care.
- They acknowledge the crisis of isolation and the need for mental health support.

- The longer we ignore tough problems, the more entrenched the interests become that profit from the status quo
- Challenges with private insurance industry: denial of care, prior authorizations, limited access to medication and rehab, burdensome requests for information
- Mental health care has historically been inadequately reimbursed and limited in sessions
- Recent proposed rule by President Biden to strengthen mental health parity law and prevent abusive practices
- Negotiating drug prices through Medicare program to save taxpayer money
- Loneliness and isolation are real problems with significant impacts on mental and physical health
- 1 in 2 adults in America report measurable levels of loneliness, higher among young adults and adolescents
- Loneliness is associated with increased risk of depression, anxiety, suicide, cardiovascular disease, and dementia
- Loneliness and isolation are critical public health challenges hidden behind stigma and shame.

- Loneliness and isolation are significant public health challenges that are stigmatized and need to be addressed.
- Participation in community organizations has declined over the past 50 years, leading to fewer opportunities for people to connect and get to know one another.
- Factors such as increased mobility and the convenience of technology have contributed to isolation.
- Social media has replaced in-person connections and can negatively impact self-esteem and relationships.
- The lack of human relationships and wisdom has had detrimental effects on mental and physical health outcomes.
- Many people struggle with loneliness, even if they appear fine on the outside.
- The use of technology deprives our nervous system of normal development and can lead to negative consequences.
- Social media does not allow for genuine connection and can contribute to aggression in online interactions.
- There may be a potential for a youth rebellion against these technologies, similar to past rebellions against harmful substances or systems.

- There is a growing movement among young people to distance themselves from social media and devices.
- Some families are choosing to delay social media use or set boundaries around it.
- The business model of social media platforms is based on how much time users spend on them, which can have negative effects on mental health.
- Adolescents who use social media for 3 hours or more a day have a higher risk of anxiety and depression symptoms.
- Social media can expose kids to harmful content, bullying, and harassment.
- It can also detract from sleep, in-person interaction, and physical activity.
- Parents need support and policies to protect their children from these harms.
- There should be safety standards, data transparency, and limits on screen time for kids.
- Real life is happening offline, and social media often distorts reality.

- Lack of open, honest, and respectful conversation during the pandemic hindered the response and contributed to division and polarization.
- Building trust, effective communication, and staying united as a country in the face of adversity are crucial for future pandemics and national security.
- Efforts are being made to acknowledge and understand people who feel harmed by vaccines, and data analysis is important in determining causation.
- Contextualizing vaccine side effects with other medications and clear communication is necessary to address concerns.
- Committees with diverse backgrounds and voices are suggested to provide a more relatable and vetted message to the public.
- The speaker discusses the importance of building a diverse community core to disseminate public health messages during COVID-19.
- They emphasize the need for different voices and perspectives in delivering these messages to different communities.
- The speaker suggests that media networks should feature more diverse faces and voices to increase trust and representation.
- Funding for community organizations that are on the ground and have trust within their communities is crucial for effective public health messaging.
- The speaker addresses concerns about the relationship between big pharma, government, and public health initiatives, highlighting the need for independence and transparency in medical advice.
- They acknowledge the influence of incentives and the importance of evidence-based decision-making in prescribing medications.
- The speaker believes that public health decisions should not be influenced by pharmaceutical money.
- Their office does not accept money from any industry, only taxpayer money allocated by Congress.
- The speaker believes that society has become reliant on medication as a quick fix for every problem, neglecting the importance of behavioral and environmental changes for health.
- They propose the idea of small committees with diverse expertise to provide holistic care for patients.
- The current medical model of individual appointments and referrals is inefficient and burdensome for both patients and clinicians.
- The speaker suggests that the business model of medicine needs to shift towards value-based care to prioritize efficient and integrated multidisciplinary care.
- They acknowledge the crisis of isolation and the need for mental health support.
- The longer we ignore tough problems, the more entrenched the interests become that profit from the status quo
- Challenges with private insurance industry: denial of care, prior authorizations, limited access to medication and rehab, burdensome requests for information
- Mental health care has historically been inadequately reimbursed and limited in sessions
- Recent proposed rule by President Biden to strengthen mental health parity law and prevent abusive practices
- Negotiating drug prices through Medicare program to save taxpayer money
- Loneliness and isolation are real problems with significant impacts on mental and physical health
- 1 in 2 adults in America report measurable levels of loneliness, higher among young adults and adolescents
- Loneliness is associated with increased risk of depression, anxiety, suicide, cardiovascular disease, and dementia
- Loneliness and isolation are critical public health challenges hidden behind stigma and shame.
- Loneliness and isolation are significant public health challenges that are stigmatized and need to be addressed.
- Participation in community organizations has declined over the past 50 years, leading to fewer opportunities for people to connect and get to know one another.
- Factors such as increased mobility and the convenience of technology have contributed to isolation.
- Social media has replaced in-person connections and can negatively impact self-esteem and relationships.
- The lack of human relationships and wisdom has had detrimental effects on mental and physical health outcomes.
- Many people struggle with loneliness, even if they appear fine on the outside.
- The use of technology deprives our nervous system of normal development and can lead to negative consequences.
- Social media does not allow for genuine connection and can contribute to aggression in online interactions.
- There may be a potential for a youth rebellion against these technologies, similar to past rebellions against harmful substances or systems.
- There is a growing movement among young people to distance themselves from social media and devices.
- Some families are choosing to delay social media use or set boundaries around it.
- The business model of social media platforms is based on how much time users spend on them, which can have negative effects on mental health.
- Adolescents who use social media for 3 hours or more a day have a higher risk of anxiety and depression symptoms.
- Social media can expose kids to harmful content, bullying, and harassment.
- It can also detract from sleep, in-person interaction, and physical activity.
- Parents need support and policies to protect their children from these harms.
- There should be safety standards, data transparency, and limits on screen time for kids.
- Real life is happening offline, and social media often distorts reality.

- The images we see on social media are not representative of people's entire lives
- Social media and lack of unstructured playtime are impacting children's mental health and development
- Unstructured playtime helps children learn important social skills
- The hyper-structured lives of children today are causing a lack of creativity and reflection
- Adults should also limit their screen time and create tech-free zones
- Parents should delay the use of social media for their children and create sacred spaces that are technology-free
- Parents should have open conversations with their children about social media use and set boundaries
- Adults should lead by example and limit their own screen time, especially during sacred times with their children.

- The speaker encourages parents to keep devices away during sacred times with their children
- Behavior change is easier when done with friends or family members who can hold each other accountable
- Social media use has become reflexive and addictive for many people
- Disconnecting from screens and social media can have a positive impact on mental health and neuroplasticity
- The speaker suggests teaming up with others to address these issues and promote health
- The speaker thanks the interviewee for their time and discusses the challenges they face
- The speaker emphasizes the importance of human connection and the need to address widespread loneliness
- The speaker believes that society has become disconnected and disinvested in one another
- Small steps can make a big difference in promoting human connection
- The speaker discusses the need for a national identity based on kindness, generosity, courage, and service
- Values should guide decisions and actions in personal and professional life

- The speaker wants America to focus on its values and identity to be a beacon of hope for the world.
- Many countries are struggling with loneliness, anger, and mistrust in institutions.
- Love is a powerful source of healing and can help us through difficult times.
- We all have the power to help each other heal and create a better future.
- The speaker appreciates the interviewer's efforts and good intentions.
- The podcast encourages subscriptions, reviews, and support for sponsors.
- Momentous supplements are recommended for those who benefit from them.
- The speaker can be followed on social media and subscribed to the Neural Network newsletter.

- Social media images are not a true reflection of people's lives
- Lack of unstructured playtime and excessive social media use are impacting children's mental health and development
- Unstructured playtime helps children learn important social skills and promotes creativity
- Adults should limit their screen time and create tech-free zones
- Parents should delay social media use for children, have open conversations about it, and set boundaries
- Disconnecting from screens and social media can have positive effects on mental health
- Society needs to address widespread loneliness and promote human connection
- Values should guide decisions and actions in personal and professional life
- Love is a powerful source of healing and can help create a better future

In this episode, my guest is Dr. Vivek Murthy, M.D., the acting U.S. Surgeon General who earned his undergraduate degree from Harvard and his M.D. from Yale School of Medicine. We discuss nutrition, food additives, social media and mental health, public health initiatives to combat the crisis of social isolation, the obesity crisis, addiction and other pressing issues in public health. Dr. Murthy explains the role of the U.S. government in promoting specific public health issues and the steps needed to rebuild public trust in scientific and medical information. We also discuss health care accessibility, insurance barriers and individual versus team-based medical care. We also discuss topics gleaned from listener questions, such as the facts and myths about “Big Pharma” and “Big Food” industries, scientific research and public health policies.
For show notes, including referenced articles and additional resources, please visit hubermanlab.com.
Thank you to our sponsors
AG1: https://drinkag1.com/huberman
Maui Nui Venison: https://mauinuivenison.com/huberman
ROKA: https://roka.com/huberman
LMNT: https://drinklmnt.com/huberman
Momentous: https://livemomentous.com/huberman
Timestamps
(00:00:00) Dr. Vivek Murthy
(00:01:53) Sponsors: Maui Nui & ROKA
(00:04:35) Surgeon General Roles
(00:07:44) Illness Framework, Enhancing Wellbeing
(00:12:42) Priorities as Surgeon General
(00:19:50) Public Health Message Distribution
(00:28:24) Diagnosis vs. Optimizing Health
(00:33:04) Sponsor: AG1
(00:34:01) Food Additives, Highly Processed Foods, Food Availability
(00:39:11) Difficulties Addressing Health Issues & Highly Processed Foods
(00:49:53) Retribution, Integrity & Public Trust
(00:54:41) Company Opposition
(00:58:32) Sponsor: LMNT
(00:59:50) Public Health Communication, Masks & COVID-19, Public Trust
(01:07:01) Masks, Humility; Building Public Trust
(01:10:45) Rebuilding Relationship to Public, Vaccines
(01:17:41) Community Core & Diversity; Federal Funding
(01:24:55) Big Pharma, “Pill for Every Problem” Society 
(01:31:48) Interdisciplinary Medical Teams, Individualized & Value-Based Medical Models
(01:38:44) Insurance Barriers, Mental Health Care, Drug Prices
(01:44:40) Isolation Crisis, Social Disconnection, Health Risks 
(01:49:15) Community Organizations & Modern Life, Social Media
(01:56:36) Youth & Social Media, Parents, Policy Change
(02:06:45) Real Life vs. Social Media, Kids & Playtime
(02:11:56) Social Media Advice for Parents
(02:20:43) Society & Disconnection, Human Connection & Service
(02:31:20) Zero-Cost Support, Spotify & Apple Reviews, Sponsors, YouTube Feedback, Momentous, Social Media, Neural Network Newsletter
Title Card Photo Credit: Mike Blabac
Disclaimer

Welcome to the Huberman Lab Podcast, where we discuss science and science-based tools for everyday life.

I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine.

Vivek Murthy is a medical doctor and acting Surgeon General of the United States.

As Surgeon General of the United States, Dr.

Murthy oversees more than 6,000 dedicated public health officers, whose job is to protect, promote, and advance our nation's public health.

Murthy received his bachelor's degree from Harvard University and his medical degree from the Yale University School of Medicine.

Today's discussion covers some of the most important issues in public health, not just within the United States, but worldwide, including nutrition and the obesity crisis, as well as food additives and why certain food chemicals and additives are allowed in the United States versus in other countries.

We also discuss mental health, the youth mental health crisis, the adult mental health crisis, and the global crisis of loneliness and isolation.

That is whether or not big food and big pharma industries actually impact the research and or decisions that the US Surgeon General takes in his directives toward public health.

And of course, we discussed some of the major public health events that occurred over the last 5 years and the current and future landscape of how to restore faith both in public health officials, in public health policy and science more generally.

By the end of today's episode, you not only will have learned a tremendous amount about public health and why you hear the particular public health directives that you do, but also how to better interpret future public health directives.

You will also come to learn that as Surgeon General, Dr.

Murthy has both an extremely challenging job, but 1 that he meets with a tremendous amount of both rigor and compassion.

Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford.

It is however, part of my desire and effort to bring 0 cost to consumer information about science and science related tools to the general public.

In keeping with that theme, I'd like to thank the sponsors of today's podcast.

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Thanks so much, Andrew, and please call me Vivek.

My understanding based on my internet search is that the role of the US Surgeon General is to provide scientific information on how to improve health and reduce risk of illness and injury.

What are some other roles that you play that perhaps would not come up in a top hit Google search that I ought to be aware of and that our audience ought to be aware of?

Well, here's how I generally explain to people.

There are 2 primary roles the Surgeon General has.

1 is to engage with the public and make sure that people know about critical public health issues so they know what they are, how to protect themselves and their families.

The second role of the Surgeon General is lesser known but it's equally as important, which is to oversee 1 of the 8 uniformed services in the U.S.

Government, and that is the United States Public Health Service.

Many people are familiar with the Army, the Navy, the Air Force.

Public Health Service, which is 6,000 officers.

They include doctors, nurses, physical therapists, pharmacists, public health engineers, a whole range of healthcare folks.

And their job is to protect our nation from public health threats.

in a major way in West Africa, we sent hundreds of officers to West Africa to set up the Monrovia Medical Unit in Liberia to treat people with Ebola.

Domestically, when there are hurricanes or tornadoes, we dispatch officers and deploy them to go help strengthen the public health infrastructure, but also to provide direct care.

We deployed thousands of officers during COVID.

So these officers, I'm incredibly proud of them.

They could be doing lots of stuff outside government, in the private sector, probably making a whole lot more money and working a lot less hard, but they're really committed to protecting the public health of the nation.

So I have the privilege of overseeing that service as Surgeon General, and Those are the jobs that I've signed up for in this role.

And if I understood correctly, these people, these public health officers that presumably are made up of physicians and licensed psychologists and nurses and so forth.

You said they could be making substantially higher incomes in the private sector, but the work that they're doing with you is their sole career at this point?

They're completely devoted to that, or they're doing this as a side hustle?

No, they are full-time government employees and members of the public health service.

Their day job is often in public health agencies where they're embedded in communities helping day-to-day to advance public health.

And during times of emergency, we deploy them, you know, and they're extraordinarily well trained.

They're experienced at dealing with adversity, but they bring a combination of skill and heart to their work, and you really need both to be effective at public health.

I'm glad that you mentioned the word emergency, because in preparing for our discussion today, it occurred to me that in this list of roles that your title assumes, that scientific information on how to improve health comes first.

So what I'd like to talk about first is health, not lack of health, but health.

You know, so often we hear about the mental health crisis, but what we're really talking about is the lack of mental health crisis, AKA mental illness.

And rarely do we hear, for instance, what constitutes mental health.

Whereas in the domain of physical health, there's a lot of information out there about how to be more physically healthy, cardiovascular exercise, resistance exercise, yoga type exercise, mobility, et cetera.

And of course, some people have physical health ailments, and there's a lot of information in terms of how to deal with that as well.

But what I would like to know before we get into the long list of issues that our nation confronts, everything from obesity to food additives to mental health issues, what is going well?

In other words, in the last let's say 5 to 10 years, have there been any areas of physical health and mental health improvement in the US at large that we can attribute to some of the public health initiatives directly?

And let me just also say about the very first point you raised, that you're absolutely right that we have operated primarily through an illness frame when we look at health.

And in my mind that's only 1 half of the equation.

So when We are talking about physical illness, for example, as a doctor I learned how to diagnose and treat someone with diabetes or with high blood pressure or with coronary heart disease.

But we also know that even if I don't have diabetes or coronary heart disease or high blood pressure, even if I don't have any diagnosable medical condition, I may not be at an optimal level of physical health.

I may not be able to, for example, walk around the block without getting short of breath.

I may not be able to play with my kids because my physical fitness and stamina is insufficient.

I may not be able to lift my luggage when I go to the airport because I don't have enough strength in my body, yet I wouldn't have a diagnosable mental illness.

So I think it's easier to understand there with physical health that we're not just aiming for lack of illness, we're aiming to optimize our physical health.

And I think when we talk about mental health, people think we're just, the sole goal here is to prevent diagnosable mental illness.

That is 1 goal, to both prevent and to manage mental illness when it arises.

But we also need to recognize there's a whole other half of the spectrum where there are people who may not have diagnosable mental illness but are not operating optimally in their lives and that's detracting from their fulfillment, from their functionality, like in not just at work but also in their communities and in their families.

And so I think part of the conversation that I want us to have as a country is about how to optimize mental health and well-being.

And that includes preventing mental illness, but it is much broader and bigger than that alone.

Yeah, I think it's so important that we recognize that treating disease is critical, obviously, but that there's a lot that can be done to improve one's health even in the absence of any known disease.

And you've got all these officers, these incredible physicians and nurses and people at your disposal.

My hope is that they would also be accessible for and currently carrying out efforts to transmit information to people about, hey, here are the things that you can do every day, every week, every month in order to make your life as healthy as possible, as well as rushing in under conditions of public health crisis.

And it's certainly, you know, many of our officers do focus on this broader rubric around well-being but it's part of how we need, I think, the broader health system and public health system to operate even outside of government.

And This I think will require significant change and shift in how we think about our jobs.

Like when I went to medical school, the vast majority of the focus was on diagnosing and treating illness.

It was much, much less focused on thinking about how to enhance wellbeing.

And when you ask and talk to people in their lives, it becomes clear that they want to do more than just prevent diagnosable illness.

They wanna be able to walk their child down the aisle.

They wanna have the endurance to do that.

They want to be able to be independent often and carry their groceries or carry their luggage.

This is why I think we've got to broaden our focus in public health.

By the way, I was not expecting to serve in government.

This is not part of some 5, 10, 30-year plan.

When I was a kid I was interested in medicine, but I always thought I was going to practice medicine, you know, like my dad did, and like the clinic my mom ran, you know, set up, put up a shingle, see patients and be a primary care doctor and feel good about the work I was doing.

But what happened to me along the way is, you know, I trained in medicine, I got interested in technology, spent 7 years building a technology company that was focused on health.

I became increasingly worried about the way we were delivering health care.

I felt like our health care system was broken.

We were focusing on treatment solely and not enough on prevention.

So I started getting involved in advocating for a better health care system with doctors around the country.

When despite all that I still never thought I would work in government, but in

is when President Obama's team had reached out to me and asked if I'd be interested in considering the position of Surgeon General.

And what was interesting to me about this position is it's actually very different from most positions that are appointed by president and government in that it's supposed to be an independent position.

So my agenda, the issues I choose to take on are not determined by a president or a party.

They're determined by science and the public interest.

You know, and that's what guided me in that first term when I served and when president Biden asked me to come back and serve as Surgeon General a second time, that's what's guided me here too.

So Biden is not sending you notes saying, hey, could you put some effort into, you know, getting messages out about, you know, COVID, or could you put more effort into getting your team over to Maui to deal with the tragedy there, which is a long arc tragedy, right?

We get the news in a blast of this happened, and then the next blast comes in about something else and we forget that there are physical and mental health crises that are ongoing and then I have to imagine then start to overlap with 1 another or is it so is it your decision where and how to deploy the financial and human resources like okay we're gonna put 10 people on Maui yeah we're going to put you know 5 people in the central states you know going around talking to major organizations about what they need to do to prepare for this winter.

Miners are the listeners of this podcast at some level.

It used to also be my bulldog Costello, but.

My boss, my wife, and my 2 kids who are 5 and 7, I do what they tell me to.

So, But how we make our decisions in the office, actually, it's a bit different with those 2 roles.

So, with the second 1, with overseeing the commission core, our 6,000 officers, there, the decisions about how and when we deploy officers are collaborative.

So we work with other colleagues throughout the Department of Health and Human Services, we work with people in FEMA, across the administration, but we also work with states.

So sometimes states, often states will put in a request and say, hey, we need support here.

So we'll work with colleagues across our department to say, OK, well, we can mobilize our commission corps officers.

And then collectively, we will send a team out there.

So for example, we have officers helping in Maui right now, particularly with mental health needs, which are, I worry, only going to continue to grow over the weeks and months ahead.

On the other side of the house, when it comes to deciding which issues we engage with the public on, like in this case mental health has been a big focus area for me.

On that front, while we certainly are open to suggestions from the public, members of Congress sometimes say, hey, can you help the public understand about this issue?

A lot of people have ideas and opinions, but the decision about which issues to focus on, those are our offices.

And to me that's important because part of the reason over time I believe the public came to have some degree of faith and trust in the office is because they hope that the office is functioning the way you hope your doctor is functioning, which is being an independent source of information for you, and a source that has your best interest at heart, that's not being pulled aside by political interests or by other agendas, but the primary agenda is how can I help your health?

And so for me, like we have to make an independent assessment there and say, okay, where is the need the greatest here?

Where can we make the biggest difference?

Sometimes we may not build an initiative on an issue and that doesn't mean that that issue is unimportant or that it's not affecting a lot of people.

But we have to make hard decisions about where to put limited resources.

And so when I was a surgeon general, the first time 1 of the big areas I focused on was the opioid crisis that we're dealing with, as well as the e-cigarette use among youth, because we were seeing a dramatic increase among kids in e-cigarette use.

Can I just ask you, sorry to interrupt, but I think it's relevant here?

Has that increase continued or e-cigarette use, aka vaping?

Yeah, so we still see, Unfortunately, there's been some improvements, but we still see way too many kids who are using vaping devices early on.

And part of what we did from our office is recognizing that.

We actually issued the first federal report on e-cigarettes in youth.

We call the country's attention to the fact that this is a crisis.

We worked with members of Congress to talk about the kind of action we needed from a legislative and regulatory perspective and worked with colleagues at the FDA and in government as well.

But there are 2 things that are really most important in guiding our choice about priorities.

We look at what the numbers actually tell us about the impact these issues are having on the population as well as the trajectory of rise.

If something's getting dramatically worse and people don't realize it, it might be an area for us to focus.

But the other critical factor is what I hear from people on the road.

So I try to spend as much time as I can visiting communities across the country, doing town halls, meeting with community members and just trying to frankly just listen to what's on their mind.

And that's where I actually get a lot of information as well.

That's actually how I came to focus on the issue of loneliness and isolation.

It wasn't because it popped up in a report as being the leading public health issue in the country.

whether I was talking to college students, talking to retired Americans, talking to parents in rural areas and urban areas, I kept hearing these stories about people who felt like they were all on their own, or they felt invisible, or they felt if they disappeared tomorrow, no 1 would even care, or they felt like they just didn't belong.

And it's heartbreaking to hear that from anyone.

It's particularly heartbreaking to hear it from kids who you hope are entering life and looking forward to what comes, but many kids weren't feeling that way.

That is very useful context and we will get back to the isolation crisis, such an important initiative that I just will thank you now for having put out the message on social media and elsewhere about that.

Because I think 1 of the questions I have in light of what you just said is it's clear that you've got your ear to the ground, you're talking to different people.

It's also critically important that people hear from you and know not just what's happening, but that you perhaps want to know what, you know, where the issues lie and what the actionable steps are that people can take, right?

And I think that we now live in a hyper-connected world.

So, you know, in fact, I'll just say that 1 of the reasons I launched this podcast is in 2020, I was going on podcasts talking about things like maintaining sleep and circadian rhythm and stuff from my lab related to trying to adjust anxiety under conditions where I think everyone was anxious and sleep rhythms were disrupted, et cetera.

And I was somewhat surprised that I didn't get a warning on my phone.

Hey, make sure you're getting morning sunlight.

I'll get a warning that I might get a warning, but it's only a test warning.

I'll get 3 of those yesterday, living here near the coast.

But I don't think once during the pandemic did I get a email or a public service announcement saying, hey, if you are going to be indoors a lot, you're going to have to be mindful of maintaining your circadian rhythm.

Because if you're not, I mean, we know based on hundreds of studies now that drifts in circadian rhythmicity are a precursor to mental health issues.

I mean, in fact, there's a new idea that many, not all suicides are preceded by a period of disrupted sleep, which is, you know, kind of makes sense, and it's not causal, of course.

But how come during the pandemic we each and all as US citizens did not get an email or a text message saying, hey, these are 5 things that you need to do every day to try and stay as stable as possible in this very uncertain landscape that we're in?

And I think it's a reasonable and a very good suggestion to say that, hey look, there should be a clear and comprehensive way that we can get messages out to everyone.

Like if we were working in a hospital system and there was a safety issue that came up, there would be an email sent to all the hospital staff members saying, Hey, this is something you need to be aware of.

So I think it's a reasonable expectation.

Practically if you go back though over the last 20, 30 years from on a, on a health issues, there hasn't been sort of an agency or an entity that has sent emails out to everyone.

First of all, how to send an email out to everyone in America is not a simple proposition either.

There are some legal issues you'd have to deal with as well.

But You could do a night where you go CNN, Fox, NBC, ABC, New York Times, Wall Street.

Like you could hit the right wing, the left wing and

But 1 video just where they all agree like, hey, this is important information.

Yeah, so I would say that that kind of messaging, I would say through traditional media certainly has happened, and it happened during COVID.

It happened, for example, when in the first year of COVID, I was a private citizen in the prior administration.

But I watched both then and at the beginning of the Biden administration, many officials would go out in front of cameras and say, here are 3 things you need to do to keep yourself safe, you know, from COVID.

A couple of challenges I would say here is that, number 1, even if you hit all the major network and cable news shows, you're still not reaching everyone.

Because we're living in a society where increasingly people are not watching TV, right?

They're getting their news from other sources.

The other thing that's important to know is that attention shifts quickly, you know, in traditional media also from issue to issue.

And so you might get a clip, you know, out at a certain day or you might get on all the Sunday shows, for example, but the next day, you know, that message isn't necessarily there, you know, it's gone and people's attention has also switched off too.

So they were, I mean, I can count and, you know, we've logged probably thousands of interviews at this point that we've done with mainstream media with sort of concise messages about 3 things you can do to protect yourself, et cetera.

But I think 1 of the things we don't have right now in the country, and this is, I think, a bit of a health infrastructure challenge, is we actually don't have a quick, efficient way to reach everyone in the country with a health message.

Just like what you said, you know, you wanted to get that message about 3 things to protect yourself from let's say COVID or 3 things to do to support your health and wellbeing during a time of crisis.

I mean, again, like not just the flood warning, but the daily, because I do think that most of mental and physical health is

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U.S. Surgeon General Dr. Vivek Murthy: Efforts & Challenges in Promoting Public Health