Healthy Longevity: New Strategies for a New Normal

Hello, my name is Nora super and I'm the senior director of the Milken institute's center for the future of Aging to our session on healthy longevity. New strategies for a new normal today, will be discussing the opportunities to transform the way. We age ensure Better Health function and productivity during longer life spans. Human life span has increased dramatically. Since the turn of the 20th century Judah, breakthroughs in medicine, Public Health and Social, and economic development. The current decade was to do you want to

progress unhealthy longevity with major International in this initiative away from Madison has launched the global Grand Challenge on Health and Longevity in the World Health Organization declare 2020 to 2030 the decade of healthy aging as an opportunity to bring together government. Civil Society, International agencies professionals Academia, the media in a private sector for 10 years of quote, who started catalytic converter, vaccine to improve the lives of older people their families and communities in which they live.

Yet, since March. 218000, Americans have died in the pandemic and nearly 80% are age 65 and over there have been nearly 40 million confirmed, cases of covid-19 putting more than 1.1 million. According to the World Health Organization, a large percentage of them are over age, 65 traumatically, elevated, awareness of threats, to the health of an aging population. Not just infectious diseases related, chronic condition. Inhibit opportunities to expand the healthy human lifespan. Pandemic calls for new strategies to prevent setbacks and advancing the physical

mental and social well-being, of older adults. How can I continue to advance his efforts Drive, Innovation shift policy and lead your future of healthy lungs with us. Today. We have doctor, Freddy Avenues. He's the head of hair technology practicing in a generous Interventional. Cardiologist. He also serves as an advisor to the American College of Cardiology Madison and assistant professor of adjunct at Yale University, School of Medicine. Next we have Richard Ashworth who was recently named president and CEO of tivity. Health pharmacist by Trey.

Mr. Ashworth has a keen understanding of the many factors that influence health insurance to treatment and a healthy lifestyle has joined tivity Health as president and CEO in June 2028 at the growth of Walgreens for nearly thirty years. Transforming the company into a global leader in Pharmacy and Health and Wellness. An addiction is a chief executive of the center for aging better. An independent charity located in the UK that brings about lasting changes in society. The more people can enjoy life as part of the, what work

Network itching better is focused on bringing about impact informed by evidence cross for priorities. So filling work healthy aging safe and accessible housing and connected communities. And finally last but certainly not least. Dr. Freda lewis-hall, former executive president and chief medical officer of Pfizer Incorporated. Doctor Lewis Hall, has held leadership roles in Academia in 2010. Your lowest station to the inaugural Board of Governors of the patient-centered outcomes, Research Institute.

Picture of Aging, good morning everyone and thank you for joining us. I'd like each of you to ask you the same question to get a started. I'll go to UniFirst ready for the start of the pandemic. What areas were the most promising for improving Health across the lifespan and have those areas changed over the past year. Chemistry question and pleasure to be with you all. Well, so be the areas that originally led to improvements or changes and how that goes in America. For

the most part, remain the same. And in fact, I would argue has been accentuated in their importance because of what's occurred over. So particularly, if you look at the house. Have dealt with covid-19. CR, you'll see a significant equity and I'll come across the country fairly similar to the spread. How comes it existed before we started? So if you look at how that goes from California to Mississippi from coast to coast, you end up seeing a 20-year discrepancy in life, expectancy rates tend to be

Under destructive covid-19. The question becomes, why? And we know prior to covid-19. The reasons behind the major drivers about apples in America. We're really broke one with four major categories. Categories match genetics access to Quality Health Care and social behavior. When are the major driver about that? Sounds The Lion's. Share the results we've seen before, which is an equity now, come across America. Profound be shown. As a 20-year discrepancy in life expectancy

as unprecedented has been, the Catalyst for us to see this in Greater detail. Unfortunately, very well using using the best terms I can ask for the emotional. So, I haven't changed covid has continued to accentuate, the shortcomings of our system. Shortcomings of understanding, and impacting, the social behavior are opposed to drive out there. And I think we're in a position to hopefully, do more about it now than we were. Great. Thank you. Have Richard

Howard things. What what did you see that was promising in the beginning, and how has that changed in the past year? Thanks for the question. I think, you know that the the majority of what we're seeing is not so much a change but is really an acceleration of what we already knew or were already planning for dinner. Before covid. Tivity is really focused on social engagements Fitness and Nutrition for seniors in the health and wellness face. That's why I figured it from Walgreens, which was treatment and care and everyone. I thought you know, it in terms of people's

lives to help them prepare for a while. Something like nobody can prepare for that necessarily, but for you know, how pee we can help the itching. What we were focused on before was getting as many seniors physically active as possible. And that was that's our bread-and-butter would do that to our silver sneakers program, great, and we're getting people to go to the gym to work out and just be more active covid, disrupted that like, we've never seen before, most of the participating locations in our gems were we're close to. And if you Look at what seniors are saying now about physical

activity. Is, it's just an acceleration of saying, hey, before I used to go to the gym and I used to work out tomorrow, actually still want to go back to the gym, but I want to do more of my community as well. So that was a big change that covid brought only 30% of seniors were involved in any of a digital work, as it relates to fit. Now. We're at 52%, And if you look at those that are going to continue to use digital 80% or wanting to stay with some combination of physical and digital. So to me, that's open, probably the largest changer to to

all of that in terms of social before covid 4 per cent of our senior said very often, they felt isolated. They thought alone. Now Terry covid-19 20%, So the impact of the social determinants of Health, write all those factors that impact? Where you work and where you where do you live? Covid is accelerating the discount. Challenge around those in a way that we really never seen before are enough to think on on on nutrition is another one because you know, before we will have in the things that they were doing 7.3% of all seniors are food, secure

insecure before covid, that's 5 and 1/2 million. Seniors had some type of insecurities around food prior to covid-19 in all of the stats now are progressing, Lee work. And so we were focused on those three things before covid. We're focused on those three things after, but we're going to make digital a really enjoyable part of that because it's clear that this community of of individuals is willing to engage in it. Write, thank you. And I know you're located in the UK. So you may have a different experience than our us speakers. Can you

answer this question from your perspective? The pandemic as areas where that were Muslim promising and then how those areas where the picture is very similar to what we've been to the US. AmeriCU Jenna qualities are particularly socioeconomic inequalities, which meant that between the poorest grapes in the life expectancy. Everybody said that was an issue before it. And what kind of it is just devastating consequences. So here in the UK for people with twice as likely to die from Kaiser does people from circumstances and

higher rates? Night stands at Santa Santa phrase investors. He mentioned, we work price on the issues, with behavioral issues, like physical activity, has full coverage. That's about 65. We're not doing they recommended physical activity. We've seen a real split with some people, exercising moves and some becoming more and more difficult to access the real name, to redouble our efforts to promote physical activity, Weider determinants. I also respect on helping people to stay in.

Dyson, accessible hide and seek find connections with and helping people get back into work. If she was spending so much more time as a result of doubling the effort to make sure that the existing housing stock. Until we've seen the some increase in reports of people changing digital access with Eldorado and wanting to access the internet to connect with friends and family in participation Greece. Great. Thank you so much. And I want to ask you the same question about, you know, what were some of the factors before and and what do we see

now in as many of our speakers have raised, the covid-19 crisis is play Snoop Dogg on. How do you think about how do we create change the address these disparities on a population-wide basis? Dad is looking at the system-wide effects and I want to put a friend of mine. Every time I say the Healthcare System. She says why you keep saying that? And I say, why shouldn't die? And she said cuz we ain't healthy nobody cares and it sure ain't no system and I disagree with her on the middle cuz I think a lot

of people tear in her working very hard to make changes, but it has Amplified. The fact that we're not healthy and strong group of people, less healthy if you were than others. The system is actually not as responsive to individual that are different from one another that we need them today. So I think that this has given us the opportunity to realize that we need. When is the challenges during this crisis, has been really understand what's happening to people and collect

data around, understand the issues and then arrest them with meaningful Solutions. So we need to date approaches a data information and Health Data, information tools. And these things would allow us to transform our Healthcare System from health promotion, and support at the individual level preventive Service, as well as a system redesign. We should also evaluate our current practices norms and systems as they exist. I think one of the things that we realized that contribute

to health disparities are differences in each piece of that puzzle. So, the practices and communities are different are the norms and communities are different, and the Norms in the system that serve those communities are different if you need to understand that, and the third piece would be to use the above the datum, in a better understanding of the system to address these at the individual patient and caregiver. Community level. Yeah, that's great. So when we started all of these are raised the

point that these issues are music just been as part of covid-19. And I think we know that the risk of mortality from covid-19 is related to Chronic conditions such as diabetes COPD conditions, that are more prevalent as we age. Now, you're out Facebook. Your experience as a cardiologist change the way you think about improving health health promotion. Yeah. So, thanks for the question. So I'm an Interventional cardiologist, which is generally speaking in terms of you know, where you spend your time,

often at the opposite end of what prevention. So I spent last week a week and so are we doing a wonderful wonderful job across the country to diagnose of having two heart attacks and where possible? And there's a lot of places that still our operating room into their vessels into the corner. And then if I'm reason it's causing the problem change, its trajectory of a patient, going from coast to Dad's to back to life in about 90 minutes. Country. But as was, earlier that is not a

Health Care System right? Heart attack three years ago. But now I'm meeting you on the table when your life is at risk and even if I do a great job for all the amazing teams across the country, to do a great job of the odds are, you're actually could have been significant improvement over night. And we also know they disproportionately impact people who happen to be on lower end of the book of socioeconomic status. And so question, we all need to Grapple with that is,

why are we letting this happen? Why are we not doing more? So, as a cardiologist, for the first time on the operating room table, when his or her life, is about a significantly change. Why, why could we not do more about this earlier? And why can we not do that to some mention? Of course, we already know the answers are suspended sentence with them and stakeholder system. It is well, established a job in operating room and don't spend enough time to train people

who are sick and that is a dramatic difference from where we should be. If we're trying to prevent them from getting Ellen, the first accentuated by More important treatment and vulnerable populations. Who struggled most, why are we meeting you folks? Now? Why can't I buy a meeting patients who were going to look at it? Not just in America and my hope is we can we can do things like to hear will change except our messages. Everyone all the time. Personalized approach

relations people at a different phrase for Saturday. I don't, you should want to meet me in the operating room, right? This is something I will go away over time change 2020. Policy wonk at heart. So I could, I could walk out and talk about painting systems in the incentives and why our system is that way, but I'm not going to, I'm going to turn to Richard because if you do, I think the good news is companies like tivity, Health are focusing on prevention and health promotion, their partnering with a lot of Medicare Advantage plans to really try to help people get healthy. Stay healthy

with no silver sneakers program, that you will have as well as as a nutrition oriented program to focus. On older adults, silver sneakers and social engagement things that really people look forward to, but you've had to adapt and Call recently did a survey of your silver sneakers 17. Tell us some of the highlights and what people are saying about these opportunities to still exercise and engage with that. You're right. I mean, silver sneakers have been love for a very long time, you know, where been around over 30 years

and so people understand the brand and I know what it means. And that means Fitness to reinforce, you know, if it's so important that we keep seniors active, you know, physical activity, good nutrition, good social connection can be just as impactful and your overall health outcomes than even your genetic code. So we we didn't have the opportunity to take a break, right? So, even though covid, March, April time frame where we had so many of our locations are YMCAs in our gems appropriate reason. We had to find a way to do something different and just one last thing on

this, you know, that the physical activity of keeping people, moving is all the things Freddy was just talking about. When He gets a patient in his in his practice, you know, and there are maybe overweight or they are causing them to be unhealthy Community. Reduces stress and is beneficial in managing. All the chronic diseases for these benefits are really passionate about losing. We did what most company said, like I highlighted earlier, you know, Wheatley take it. It's a digital and

fast and everybody told us not quite as digital is everybody else the wrong. This trip is very digital there on Facebook. They're connecting with their kids, their grandkids at cetera. And so we took the, you know, the kiss of the country to try it on a slope or whatever that was the time. And we hosted our first Facebook live class know. Now, we have our own proprietary platform, of course, we've got thousands of on-demand workouts available for doing 2500 classes, a week and Ashley Wright. Are over a million digital live with instructor-led. Visit since this started in the

beginning of the year. We at. So or poor, pretty, pretty jazzed about that. One thing we learn to when we surveyed our folks, to mention the survey. 75% of them are using technology. Either, tell it to do something physical for medical appointments with the socializing or Fort for fitness. And so, you know, if they weren't text Abby before, they're getting there now and 50% of them are very comfortable with using Zoom, you know, I dropped too many of our members, they know how to customize their backgrounds and then I'm inside. So it's actually pretty pretty cool. We've heard some fantastic

stories to you know, our instructors and Fitness locations. They got creative. They're taking safety serious. The one gym owner. We know teaches classes Rams coach Mel and she worked for the members granddaughter to get Zoom icon on your iPad home screen. So all she had to do is just click on that and she can get right into So basically, everybody's adapter in the key takeaway. I would say is I like having this digital options to talk to him about the vaccine. What you going to do, are we talked about Fitness? What you going to do there? And one of the things they said it's

very, very clearly is digital or virtual is not temporary. It's here to stay for. The future, is 1 of a cup of digital and physical. That's great. You know, I know there's so many directions, we could go and it's fascinating discussion. But I think we've been seeing the mental health impacts of covid on people, at least talk about that certainly exercise guide, a really important to her house and can help with things like depression and anxiety, other mental health issues, but they also can stop you from wanting to exercise her or eat, right? And in Jesus.

What a, what are your thoughts, just as a psychiatrist in terms of the mental health components and how that might impact life expectancy, and you know how well people are coping prices. Look up a little bit of the date of birth of all people, over the age of 65 or older adults in that category and younger or older as well. As older older have an improved ability if you would to mental illness. And that's kind of a bass line. If you add to it, the stressor further isolation. I remember many older adults are still working and may have been laid off.

They may either 200 or the percent of land that take care of their grandchildren. So that there is also very hot. So if you add increase isolation food and security job in security changes, in interactions with family friends and other forms of ID, Can you have the potential for increases in people who are not affected by mental illness? Of those numbers would go up but in addition to that you have stress and worry and in fact in July, there was a survey that said about 47% of people over the age of 65

were considered a worry and stress relative to the effects of Provera on their life to be a significant issue and have an impact on their house. And then all of the factors that I just named the additional factor of not having access to a primary care physician or a healthcare provider. Anyway, but now to have decreased access because of Supply, add to that increased risk for infection themselves. Become seriously ill often hospitalized. And last but not least, the number of losses

and older age groups that lead to make this a normal sleep critical issue. And so, we have to as a system if you would have health care and as individual health care provider have to be on the lookout for symptoms of mental illness, depression exacerbated, previous, mental illnesses, like bipolar disorder, and schizophrenia that may become worse. Under these circumstances. We have to be on the lookout for signs or indications. That someone may be suicidal suicidal risk for

the well. Circumstances and the oldest son, not is often on patients to seek their own health, but I think as caregivers and Healthcare Providers. We have to up our game actively looking for the symptoms and an interviewer. Thank you. I know I've been working environment as a driver of Health as an increasing social isolation, which you can turn to in a minute. When you started with that the quality affordability ability. What do you think about? What your organization doing to address that issue

facing? It sounded so we would wish I could actually younger people in their 60s. Ugly. And so we've been trying to work with designers and retailers to really understand. How come we get designed to help remind me trying to shift the market. How do we make sure that the system is really come to the fore about light and space in particular? And its complications and freedom was talking about that at mental health and we stay in the fifties and sixties, who is it?

And what are the types of policy actions by else is needed, in terms of financial services to help people. Refurbished to retrofit the homes so that they can last them a lifetime and support them to have a good quality of life. One question. Turn on the table, that's not often talked about or we talked a little bit more about technology is ageism and I was the covid-19 has really like racism at. People have really been talking about that much more openly. The me-too movement, really have more awareness about sexism in our culture.

We often say ageism is the one is in. People. Don't talk about that much. And as an aging Advocate, you know, I think that we've gone backwards and how we View and we see a lot of negative stereotypes about older people, you know, I started the conversation. We were looking at a jacket of releasing. Some people having this gift of 20 more years of life is in but we see these wide disparities as we talked about and life expectancy based on some Special terms of house that also

how well people do exercise eat right things that they do to reduce their risk, 19 and older adults, earlier about one-quarter of all, could be considered a gist, including jokes, or ridicule, and an older adults because they're content downplayed the relevance of covid-19 in nursing homes. Assisted living facilities. That we're now, going into, the seventh month of not being able to see their loved ones often, as special isolation that there's a balance. I think between protecting people from getting infected and actually having even perhaps worse Health outcomes because of

the severe social isolation. Some of that driven I believe because of Ages on people say they don't matter. We want to get everybody back to work and kids back in school. But, you know, there's other people that's just not true. That older populations very heterogeneous. How much you think ageism has to think about getting older? And, you know, maybe something strategies we can do to really give some positive reinforcement to folks about, we all know, we're all still in there. There are ways you can improve your house, no matter how old

We stayed at here with some terrible at Coventry suggesting that time. It was a cult of all the people say in Blue Point that ages and with that, but it has absolutely come to the fore and some of the responses based on policy and in the media. And again, not every day that we somehow tolerate, you. I'm having a senior moment that we stay on breast because saying, we're over the hill. And if we say about the effects, for the Ouija preventative health things.

And then, the intergenerational conflict that again. Why are houses in jobs off the Millennials and younger? And she told and again, into that generational conflict, this health Public Health measures to save the old and all of the economic burden taken by younger workers. So one of the things we've been trying to do is really counted that with recent messages examples of workers that are as likely to have been employed as a younger ages. Very similar impact that the older workers from test

processions are the least likely to get back into work. So the need for support to help Get jobs is as critical as supporting younger workers to get those first jobs. So we end up with a terrible impact, South Nest, outside entity and age discrimination in. Instructing people catching this pervasive negative results. Yeah. I'm interested to know that resonates with you and they in the US. If I'm a cop in, I think, Freddie said earlier that, you know, kind of

100% for everybody solution exists. And so, I've grown up and been exposed in many cases in the cultures, in which I have worked to, to be in a place where adults are Revere. And as they are seen as kind of necessary daily contributors to our lives, both within our homes, and within our community are often and our First Responders as nurses and nurse's aides and caregivers be there. All of these things that in many cultures. The older you are the more your revered

if you would and my dad live to be a hundred. And so I have a great appreciation for the contributions that you can make all the way up to a hundred and Beyond. Install Windows environment. What I've heard is the other end of the spectrum, if you would, which it is. Oh my goodness. What if we've been doing, we don't have the right living environment. We don't have the right of responses to protect our older community members. We haven't stopped through access the things. I'm, in many cases,

older adults, don't have access in some communities to Wi-Fi, so they can't go digital if you would. And so, we need our live in neighborhoods that are not safe to modify their lifestyles in order to Access Healthcare in other ways, if their usual away doing so, is now interrupted. So, my husband always says people don't change when they seem like they changed when they killed and so cold it has provided the heat too many communities to say we falling short on doing the Should you acknowledge to recognize to support

and to provide services to into value older adults in our community and we need something about? I'm going to go back to technology for a minute because when I was doing earlier last week that someone you said, one of the news social determinants of Health maybe access to Wi-Fi. And you know, I think we're seeing that in our dependency on technology. And so we spoke last week you express your frustration that it took a global pandemic for us to increase access to Tallahassee,

even though the technology was already there, but there are a lot of factors that stopped us from expanding that as quickly as we can. You say more about how you think technology and better text, you know, connect us, Jen hanser health and well-being and both inside and outside the medical establishment. But then also how do we ensure people that don't have access Wi-Fi can reap the benefits of Technology. And thanks so much for the question. Let me let me start with the with the disillusionment and work backwards. I completely completely agree. I think I

seen online becoming is something that we should all strive to allow our bill tours across the entire world. Spent a lot of time on Facebook. How do you get more access to don't have to go back to picking through the concept of how is so difficult to get to remote parts of the developing world? Approaches to doing that a lot like water and in order to be able to access that I hopefully will maintain and grow as well as environmental changes that are just as simply has access to healthcare. Still still boggles my mind. If I

spoke for Westminster current production. My Hope, Is that the next big innovation in healthcare doesn't require a degree of incentive system. So so that said, technology is very important role to play in. In making us human more as opposed to technical more technology plays a role. I can connect to my dad and my dad can read bedtime stories to my kids before they go to sleep East Orange Community. They feel it should be for that. I think that's where it's at again.

I don't think we can use tack to make those things better than we should. So, example, of Aging, better at home restaurant kitchen, at least it's fairly new on, unless you're a primary care. Physician is really well in the old school, way of doing things. The same family Grover. We certainly doesn't happen with our use technology today, to improve our ability to connect with humans. As well as think the words are out there tomorrow, which is fundamentally improve recitation station

in a way that makes it all better. And I think the answer to that is absolutely, and we have to figure out the rules and regulations to get there and and Generator. Beijing Express on and I mentioned this earlier setting up the home to be a place. Where is a good place to start thinking about it? But I don't think you're allowed more engaging away is a smart-ass or less. With the first fraction of raw, and at the same time, provide tools that we don't currently exists to allow us to be apart, but still be together.

You know, if anyone else want to jump in on this technology issue there. At 1:39. I just, I just wanted to add the idea that in addition, to care data, collection data analysis, and really understanding what patients people I need or want for prevention for diagnosis for treatment. And for wellness, overall is a really a teen opportunity that we haven't tapped in using technology. So, observables wearables, interacting with patients and using that. As a platform to

understand more about what might barrier having the most the most healthy years possible is still wide open for us and we have an opportunity to do the entire Spectrum. Richard I was just going to come in on and I agree with that point on on data. I think it's a pretty strong one kind of compartmentalize the problem a little bit and you know, our rule part of our country, a fourth of them don't have the support of our country. Living room access to this type of

capability, rather Broadband itself, or even know a high-capacity internet, but I think that's one thing. It's kind of looking at the disparate Urban vs. Suburban versus rule. That's one kind of Argos. You and as we know a lot of our help to spare to sit out and roll part of the country as well. And one is about education, you know, they're adapting, seniors are adopting, the technology pretty well. And 50% of them that when we surveyed on big other, pretty comfortable but the other Mike live streaming and video and things like that, but half of them aren't yet? And

so thinking about like, what Facebook does or what like apple could do or others around, you know? Educating seniors on top of the Oakland A's in the technology on the house. So I just barely point. I think that gets really local, you know, so there's a lot of ultra things that happened in communities as to why people won't engage in certain capabilities that are available to them. And community-based organizations are playing a huge role here. They can help with the gas that can help with the solution that can help connect to Providers. And technology is a big part of that. The

last thing I'll say is, I agree. You got to meet people kind of where they are and we were talking about ages of a bit, you know, but my mother and my aunts and uncles, they all have apple watches. They don't have an old person's watch. They have an Apple Watch why? Cuz it's cool and it does everything that they want to. And so thinking about how we use technology, ifitness share with my mother and it's a hidden way for me to know that she's up and about every morning cuz I can look and see how much activity sheet that, and some other small ways that technology are helping people

feed them best, but their best selves also as it relates to Health Care, Yeah, I think that's a great Point Richard and let you know. I also have a no group that we know, if somebody's not doing well. Hey, what's going on with you? I haven't really taken any steps. You know, what? A real way to bring people together. I also when you were talking about the old people watch it, you know, I think it might be a weapon. Did some really interesting were comparing services that people that have adopted and that used to be

considered, you know, you didn't want to have people come into your house, to bring your grocery store for everything. And in some ways, I think it's really help older. People also be able to, you know, how groceries delivered things brought to them at home that make them. I stay independent for as long as possible. Run out of time, but we do have a question from the audience. I want to make sure Only address. I think when we are talking a lot about the social determinants of health impact your house, one of our audience members have been you know,

where does personal responsibility coming in? So I think they said they're there are things that are certainly related to some determinants of Health. But some things up that we can do to be healthier. Where where where do you all think? So what's the role of personal responsibility and Ferb increasing your house band? That's a nice, controversial questions. Should I jump any accumulation of health issues affecting their ability to participate in society. It's very hard to talk to them about the facts.

Can help make it easier. And I think it is. It's really important that we do scientists on the instruction to 10 minutes because where we staying in the past, educate people about what's healthy about, she worsens inequalities because there's people do and those people who faced significant challenges in various. So that's why I That's what we trying to reject address. That's great. So we're almost out of town. Oh, yeah, go ahead of question. Is that I mentioned? I think we should look at the

responsibilities as a variable that doesn't change between remains. It is personal responsibility. Given the data isn't the reason why people are doing better and so is my suspicion is generally speaking regardless of what your level of personal responsibility and we're all different. Most forgiving people including myself, so I might be getting a community personal connection. And how did it go outside? A few times a day by by design that gives us some hints towards what end to work for

the most part. It's really not any better at it than others. Met is not a reason why we have Great, great. Okay. So rapid fire answer to the last question lightning round. I always like to finish on a positive note. So what do you think is the Silver Lining? What makes you feel positive right now? Healthy aging. Ready, just down to, let's go to you. First Richard. I'm optimistic because in our surveys, what we hear from most of our beneficiaries is that they want to get back to what they had before and maybe even a

little bit better. So I think digital help with that. I think they're racing the world differently than they were before in all of the trends that were better for 4 for the population adjusting accelerated. You know, this crisis has been terrible Catalyst for change. So I see a positive when the outside once we get into whatever the world is going to look like. I think a lot of folks can have a much different mindset around. I'll be going to live their lives. Yeah, so I would answer that that the changes in the

workplace. We know the older workers have wanted greater flexibility, while it's been next to the races and just need to make sure that that that continues and people already supposed to stay and work and some righteous. Great. Thank you. I free. I'm very optimistic that people have begun to do the thinking as well as the actions that respond to not just to what is happening now. With covid-19 sugar change as moving forward. So we're looking not where

we fell but where we stumbled and are beginning to think about how to remove those barriers and I think that'll give us a transformational change. That is sorely needed. That's great Friday. And other than get a dog. What? What? What other things make you helpful. That's great. Really changing will thank you all aware of your breath. There was a great conversation and looking forward to the follow-up with you. All, really appreciate you being here. Was really stimulating. Have a great day everyone. Thank

you.