 Good morning everyone and welcome back to day two of our indoor chemistry and environmental justice workshop. We're so thrilled you're with us today and excited to continue our fascinating discussions and hearing from our wonderful speakers on the second day. On the first day, you heard about indoor chemistry and all its complexity and forms, including indoor air issues. Indoor dust and chemical products and consumer products and how structural factors such as racism and discrimination lead to disproportionate burdens in communities of color in different populations and how that is a health risk that we are concerned about. Today we have a very exciting talk from Ruth and Norton was the president and CEO of green and healthy homes initiative. Before I go on to introduce our speaker of the day I'm just going to give you a quick overview of the plan. We will have a talk followed by a Q&A with our speaker for today, and then we'll have a panel discussion with our planning committee, and hopefully all our speakers from today and yesterday and all your participation live. So we would really love to hear from you we want to push the conversation forward to action and solutions. Just a reminder. So, we are focusing again on housing issues consumer products health risks and exposures. We had some discussion on governance and regulations and what do we really need to make a dent in the space right to change actual outcomes on the ground. How do we engage with communities how do we do work on the ground that benefits communities and prioritizes their needs, not the research let's say or the proposed solutions. If you are online as a reminder please post your questions in the chat and we will be looking at them and pose posing them when the time is right of course in the session. And if you are in person please feel free to come up to the microphone in the Q&A time, and the National Academy staff will help you pose your question. So with that it is my absolute pleasure to introduce our keynote speaker for today, Ruth Ann Norton. Ruth Ann is the President and CEO of the Green and Healthy Homes Initiative. She joined the organization in 1993 and has led its development into one of the nation's most effective and foremost authorities on healthy healthy housing and its impact on the social determinants and racial equity. An expert on lead poisoning prevention, healthy homes and the intersection of climate, energy and health. Ruth Ann directs GHHI's national strategy, policy framework and services to integrate climate healthcare and healthy housing as a platform for improved health, economic, educational and social outcomes for low income communities. She broadened the organization's mission by designing the GHHI comprehensive model in 2009 in partnership with HUD and CDC that is built on a framework of cross sector collaboration. GHHI's model aligns, braids and coordinates resources to comprehensively deliver lead hazard reduction, healthy homes, energy efficiency and housing rehabilitation interventions. She has been at the forefront in building the business case for healthcare investments in housing to address the social determinants of health and racial equity. Ruth answers on many boards and committees including the EPA Children's Health Protection Advisory Committee, the National Leadership Academy for Public Health, the John Hopkins Bloomberg School of Public Health Center for Education, Health Information Technology Advisory Board, and she is the chair of Maryland lead poisoning prevention commission and a federally appointed liaison member, the CDC's lead exposure and prevention advisory committee. Please join me in welcoming Ruth Ann Norton. Thank you very much for being with us today. Good evening everyone. I'm really pleased to be here and Gillian I want to just give you a special thank you for inviting me to talk about the work of GHHI. And as I said, talking about our work in the context of indoor chemistry my parents would be proud because I struggled so a little bit on the sciences growing up so, but I'm an economist who ended up in a public health mission. And I want to talk to you just a little bit about GHHI before I talk about our work. I love our work as addressing the social determinants of health opportunity and racial equity through the creation of healthier homes. But in 1993, we decided to form an organization to move forward. And I want to mention the work and the brilliance of nine parents in Baltimore, whose children had been severely poisoned by lead who were spending 28 days getting deep muscle injections and chelation to remove lead from their bodies, only to know that the housing stock to which they were going to return was likely to poison them again. In 1993 in Baltimore, we had if we put the threshold of 3.5 micrograms for deciliter the CDC threshold for lead. Today, we would be talking close to 60,000 children at the time, being impacted by lead. And that toxic legacy of lead poisoning that was keeping black children in Baltimore especially from being able to get to the classroom to fairly compete to learn so that for a lifetime, they would be able to earn and have a quality of life. That really was not an option. I was tutoring kids at the San Francisco youth center at the time that we decided to move this forward. And what I noticed was that the children who were eight and nine years of age, knew they knew that where they lived was determining the pathway of their lives. And the hope that that was taken away from that and the opportunity taken away from that was the reason that we founded on a social and racial justice mission. The coalition again to end childhood lead poisoning. But we also did it, because we knew that we had to improve from a standpoint of a moral compass, housing condition in the United States in low income communities that we had disinvested that we had disregarded and that we had allowed ill conceived policies and practices to really rob people from the long term opportunity to have a quality of life to have health, and to have a forward thinking future. We have moved that mission forward over 30 years, being investigators and science scientists in our own kind of way with our co principal investigators and our lead investigators being the parents themselves, who are living and understanding the challenges and complexities of not only lead, but rate on asbestos. The carbon emissions and benzene that are in that are in their houses every day in impacting the health of a vulnerable children, pregnant women, seniors, and all all of the folks living in these houses. It keeps us up every day, every night, right and challenges us every day are the 34 million families that live in unhealthy homes in the United States that are full of toxins and chipping peeling lead based paint, but also mold mildew and moisture and leaky roofs or poor ventilation and the carbon emissions that are coming from their stoves and their heating systems, but for which families often have to depend on for heat in the winter when the electricity goes out. What we today are looking to try to do at GHHI is to flip that script. To keep what we know informed by residents informed by communities and move from historically disinvested communities to the most resilient leaders on climate friendly healthy and safe housing to turn the $150 billion that we spend that we don't have to spend every year on medical issues and health issues caused by unhealthy housing and reinvest that as opportunity for the future to train people in community to be the risk assessors, the data collectors. I was so impressed by Paul Francisco's presentation yesterday where he talked about how and many of the other presentations talked about how do we build that together. People first, the science follows. Right. And we have really endeavored to do a couple of things have the courage of common sense, which I think comes because the evidence is there and allows us to do it. But also help to put the value of doing what is doing the right thing. What do we save what can we reinvest. And what we have focused on a lot is the health care system. Because we know if we invest in lowering the rates of asthma in reducing mold mildew moisture doing integrated pest management improving ventilation, lowering carbon emissions. Not only are we going to have dramatic impacts like we've shown through our healthy homes technical studies and great organizations like RMI and others have shown the reductions in asthma. But we know that that child is going to get in the classroom healthy and ready to learn. And in the case of the health care investments that are made in our Baltimore program. We will lower we will create savings for the health care system. So our main investor in Merrick group now well point. By investing money with GHI to do this work to address those things that are making kids unhealthy. They in turn showed that we can serve save about 32% per patient per month in their costs. That becomes business case. But most of all a human case for opportunity. And our HUD studies showed that we will reduce hospitalizations by 66%. And more importantly, improve school attendance by 62%. It is all tied to our quality of life. But it also comes, we move from the coalition and childhood lead poisoning. After achieving a 99.4% reduction in childhood lead poisoning in the most poisoned city in America. And returning $44.5 billion in economic investment back to the city and the state. That comes from a study out of Duke University of the Nicholson Center. It must be valid because I went to Chapel Hill so if they're going to say something nice about people went to Chapel Hill that's good. But the reality is, we started to look at what that meant. Where did the $44.5 billion of economic investment go? Did it go to holistically improving housing? Did it actually go back to families who had suffered these injustices? Did it fund college education? Did it fund healthier housing? And the answer was no. So we really started to hone in on how do you track those dollars from an equity standpoint? Ensure that they're getting reinvested. How do you track savings? Ensure they're getting reinvested, right? Around social determinants and social drivers of health and equity. And what do you need to make that happen so that the contractors doing the work are from the community, but they're not just also the contractors. They're the owners of the contracting companies and taking and looking at that, right? So we really started to unpack how do you leverage investments from all of the 242 lines of funding in the federal budget that actually touch housing intervention and how is that tied to evidence based practices? How is it tied to reducing toxins and improving housing condition? So that's been our work to look at those things both in our direct service programs, which we have in about seven cities across the country, and in our capacity building and technical assistance work. And today, we have probably the greatest opportunity that I know I will see in my lifetime about how do we leverage the historic investments coming from the Infrastructure and Jobs Act to put money into what we now call Justice 40 communities, but the communities that we have left disinvested for far too long, and how do we use the money from the Inflation Reduction Act to do something really important? And that is take the climate dollars that are being put out in various forms in the billions of dollars and turn that in a way to have restorative justice and health in housing. And to ensure that we're going to our hardest hit communities, that we're not bypassing the capacity building needed, the jobs improvement needed, right, to address what we are doing so that we can actually take that money and put into housing where 40% of the resolution globally is attributed to buildings and much of that residences. How do we address the 34 million households and families that wake up every day? Less prepared because their child didn't sleep through the night because of asthma may have been damaged because of lead poisoning, or where they are struggling with their energy bills. And we have this opportunity now to align, braid, and coordinate these dollars so that we really can reach a moment of equity. And for those of you who have been in this work for a long time, I was talking to the presenter from WEAC yesterday, Peggy Shepard and I 30 years ago in this fight where we're sitting on some pretty lonely islands, and we do feel, I think many people that the tide is coming to the shore, but we have to build on that. We have to take the opportunity to treat housing quality in the United States for everyone as a matter of health, of racial and economic equity. We have to ensure that we address the fact that 61% of black and brown Americans are more likely than white Americans to live in a county with heavy pollution, including particulates coming in from smelters, right? And then what's happening in their home, and how do we combine those activities really grounded in the one place that can give families security, can give them an opportunity to succeed, and build some housing stability and communities that are much, much healthier and safer. And that is today in addition to things like lead and trip and fall injuries and asthma from other sources that we're looking at is the mechanical appliances in homes. Your water heaters, your dryers. And that is being taken forward in lots of zero emission proposals for mechanicals across many states, including a paper that will come out next week in Maryland that GHHI is a part of to talk about how do we set a standard legislatively to say no more. Are we going to do that. Another issue that we also are pursuing, whether it's more politically viable or not, never stood on political viability stand on evidence and on facts is gas stoves. We know that leaky gas stoves can cause respiratory impacts, neurological impacts can really be quite damaging, right in someone's life. And it's also for many low income families, the appliance that they've hung on to for heat that it culturally even many traditions right cooking on gas cooking on flame, really important. So how do we change that socialization. How do we build confidence in the electrical systems and houses, the electrical grid, so that we can make people safer, but we have to. We have to build these noxious fumes in houses are exacerbating asthma are causing neurological impacts, and are causing those things in life, right, asthma is the number one kid and reason kids miss school. It's also the number one reason parents miss work. And eventually what we are also concerned with as more and more and more people rightfully move away from fossil fuels. That is happening so much faster in the middle and upper income communities. And this time we are committed to ensure that lower income communities will not be left behind on a gas island to pay the bill that makes them unhealthy. So we've done some really interesting things including building community advisory boards to help us. As we did when we started the healthy homes work beyond lead to move to healthier housing. How do we inform people, how do we teach, how do we have the communities as leaders to understand something that meets great resistance. Yeah, how do we take even the utilities across the country and get them to do the right thing by family so we're working on that. And we're really working to try and align this opportunity with communities on an energy health housing and equity standpoint, right. And there's a, if you want to read a little bit more about sort of how this work happens Dana Borland from the JPB foundation wrote a wonderful book on the intersectional crises that we face between climate housing and health and I would really recommend that. We see climate change, and the dollars coming as maybe a pivotal and seminal moment to actually improve housing stock, greater than we ever have that we can shift from disinvestment. And those ill conceived and unjust policies, whether it's redlining which I hate to say began in Baltimore, Maryland. Whether it's a disinvestment that occurs because housing is bad. So we're going to disinvest more or we're going to build the highway through a community and increase asthma and disenfranchisement of families right. So we're going to shift from that disinvestment strategy. These are some of the things that are also common sense matters. I think somebody yesterday talked about something that I think is always a point that we have to solve for in communities across America. 52 to 62% of the time and especially larger urban centers, weatherization and energy efficiency dollars that are intended for our lowest income communities are deferred or declined or never invested. Because we're not taking care of the toxins in housing because we're not taking care of the health and safety in housing. And we have to do that but when we do it. And we did a study for the Obama administration and when we do that. We can move from that 52% deferral rate to a 92% success rate right, and that matters to the quality of life and health, and how the rest of the home as an envelope works, and we have to take that same view. We have to take care of climate dollars, where we ensure that the contractor companies are owned by community that the risk assessment and data collection is done with community led by community as I said, right, this working together, building a whole house model is the pathway forward and we know that it saves about 26% for governments when they do an integrated strategy, which means for every four homes they do they can do five. Right. It means that workers cross trained will start at about $4 to $8,000 higher than those who are individual skilled right, and we have that opportunity. We also might have to measure what we do. Measure the health outcomes and take those savings back to health care. And urge them in the reinvestment strategy, whether it's Medicaid or the state health departments, or hospitals like Lancaster General Hospital, part of the University of Pennsylvania health system, who in Lancaster. The state of Pennsylvania is investing with GH hi $62 million collectively in the city of 90,000 people in a county of 500,000 to make housing lead free, healthy, and with the whole house bill passed by the state of Pennsylvania that looks at how do you build all of this together with climate. We can have an entire community of healthy housing it's the same approach now that's being taken by the state of Maryland under the more administration, a whole house strategy, and so many places like built to last in Philadelphia, because they know that it's not only economically viable. It's better for wages and wealth, right. But it improves the health of communities and measurably. So we, we have health care investing all over the country, right, but we also have really good utilities who understand this and are thinking progressively like Detroit energy who's a co investor with us in the Detroit home repair fund that's funded led by the Gilbert family foundation. And that work and the whole house strategy matters. But I, the reason we began it. I'd love to say was completely on the evidence, but it wasn't. It was in part that, but it was mostly family members saying to us that when we originally did the work on lead that we would leave. And there are still so many other things that were harming their lives. And we had, I have a worker colleague on our team Larry Brown, who's worked with us for about 22 years. And Larry and I were sitting in the office and he leads our construction work. And he came in and he said, I can't do this. If we're going to just replace windows for lead and do chipping paint. And now that so much else is happening in my community that we're not addressing. So we started research and we started small. We started building $10 radiator covers because 1300 kids in Baltimore were going to the hospital with second and third degree burns because of radiators. Then we started a little bit of pest management, then we started to learn about indoor air quality. And we started to build that strategy around healthy housing and one day at a time pulling one thread at a time and listening to our lead investigators the families, we began to come up with the theory of what the work we're doing. So we address in our work led asthma injury. Things like radon and asbestos energy efficiency and weatherization and electrification and decarbonization. And one thing I will say for electrification, besides helping to prevent fires, it also adds value to housing. And in all of this as we build and track the dollars of equity investments right and whether they are real investments of equity. Electrifying housing is also often improving the value of homes. And one of the things that we have to close in this country is the eight to one gap in intergenerational wealth transfer by real estate between the black community and the white community. The chasm is really wide. And often because we undermine the investments in housing in black communities in this country. So this is our model of aligned grade coordinate, right, where we are bringing in philanthropic dollars, private sector dollars to healthcare utilities and private private investors and leveraging the federal state and local money so that we have one comprehensive assessment. All set in evidence, right, and was co created with HUD and DOE and EPA and CDC. And that we are using that then to look at scopes of work and where do we braid money from, how do we coordinate resources, and how do we track that data with community on the outcomes and how do we share that transparently with community. So our whole house approach right has had some pretty good outcomes 66% reductions in hospitalizations as I said 62% improvement school attendance. 88% of our parents report being able to better get to work because their kids not in the emergency room, not in the hospital sleeping through the night not having other problems related to that. So we're cost savings for energy, really quite good as well. So I'm going to kind of go past this because I know only have a minute or two. I'm happy to talk about the really, I think, interesting things and broad things that GHI does in Q&A. And as we measure this work on the racial equity metrics of community engagement, where's the data, what are the lessons, who's leading, who's getting those dollars. Right. We look at how are we also meeting those climate goals, how are we moving forward things like zero emissions and appliances, electrification standards. But most of all, how does it come down to families. So this is Coralus Phillips long time public servant worked in the state's attorney's office in Baltimore. And at the age of 67 was about to lose her house. Her energy bills were high she did not have working mechanicals. She had asthma and asthma gens in her home. And the lead in her house and was fearful for her grandkids to come into the home. And she was looking at a future about how to afford to move out of a house she could no longer afford or maintain. So we took a whole house approach with her in the past year and included in that full electrification, full decarbonization, replacing all of those mechanicals. And in the first several months, her utility bills have dropped she reported in a lunch $120 a month we have $100 a month here. But most of all, she feels better. She's stable and she has a home in which she can age gracefully and with health in into the future. And is now I think our biggest advocate for induction stones, as well. We also have Cameron, right, who even went who suffered greatly from asthma. And we, this is not a home where we did the full approach, but even the smaller things of addressing housing to improve indoor air quality to ensure that there are more measures to lower the asthma gens and some of the toxic air issues, and has moved from multiple hospitalizations and ER visits to none. And we have hundreds of these stories right as we build on the capacity of communities to go forward. And I want to say the last thing I want to say is there's a lot of GHH eyes in the world that exists today, we started one person and a budget of $17,000. And today we are doing extraordinary work. But there is extraordinary brilliance in communities across this country that we cannot should not overlook. In March we held a deep of decarbonization electrification convening around healthy housing in Baltimore with 85 groups around the country that need real investment, because what they do and what they will do is far better than anything that we have ever done to date. So thank you for having me and I guess we're going to do a little Q&A and if you have anything to ask but most of all I'm grateful to you. I was so impressed with what I saw yesterday and what going to be watching more of the recordings but to do the brave work that you do and to want to translate that into environmental justice. We need more of that every day and to you I'm grateful. Thank you. So what are we doing. You don't mind joining us at the panel table. Sure. Okay, so I know who I am. Yes. That was a really excellent Q&A with us. That's a wine or something right. Any of questions and again I'm super grateful to Dr. Gillian middle said for really being the connect. Thank you so much for joining us together for this call. No mind I'll start us off with a couple of questions that I have for you and then we can also check online to. So I have, I have a lot and what a wonderful presentation. All our discussions today and yesterday and just hearing. I feel like there's a little bit of a disconnect perhaps between the research. Right and I can see Gillian is agreeing with me. The research community we're moving a lot more towards getting signals from our funding agencies that let's think of solutions. For solutions oriented let's think of how to make a difference right. Oftentimes you're kind of thinking of one type of intervention or focusing on one problem and trying to devise a solution to it. In the research world and we talked about community engagement and we can get into that a little bit later perhaps. Because in your talk is very sort of fascinated and impressed by this whole home approach right this comprehensive holistic take on solutions and interventions and making an actual difference on the ground. So I guess from your lens and your experience. What are we missing in the research world with connecting with the type of evidence that you need for example. To find these programs to implement them if you were to ask a set of researchers can you show me evidence on XYZ. This is the most impactful type of work you could be doing so that in practice we can really make a dent in people's lives and health outcomes and environmental justice what are those thoughts that come to mind. I'll answer your question but I have a bunch of thoughts going in my head right so I come Baltimore right. So many people knows box right and we're re occurred a DNA and made dollars over the course of time. Sorry, am I, is that better. This is the city where lead studies left black children in houses while they got poisoned because we were trying to get information in the researcher trying to get information. And that left deep distrust in a community. And you know I, I, at one point in time, and when we were doing a big redevelopment project in the city of Baltimore. And we needed to think about how do we do demolition of these older houses that were full of lead and other toxins right and spastic another toxin. And how do we do that safely so we had a large community meetings right. And I remember that we invited, not only Hopkins, but we invited Morgan state, because I wanted to build better trust with the community and have Morgan state and, and what was interesting about the community in that, but I loved in the raw honesty was the push back to bringing Morgan state in at the time, who has done just an amazing job on community health and has really changed the fabric of how we did research in Baltimore. But at that time, the community said where have you been you've been on your campus. Right, whether you're an HBC you are not even on your campus behind your walls, and you haven't been here talking to us. So it taught me a lot about not to make any assumptions. But all of it is that there is deep institutionalized distrust for a reason. And the ways that we've found to get past it and we have, we're not the ones with all of the answers right, constancy and consistency. For my own self the reason I've stayed at GH hi not gone somewhere else is because I made a commitment in 1993 to these that I would be with them as as one person as an ally as to do the work. And that builds trust to have constancy, consistency and presence. But the other is to learn to invite community in early to understand what are the problems, regardless of any community, what are the problems that communities are actually facing. You know, whether it's the asthma rates in LA because that all the housing sits right next to the highway, or transportation issues or, or, you know, lead in housing, whatever that is. There are many things that address what people are facing. And when you start when they start to see success with what you're doing. They're more likely to be with you in the next step. But the other is to be overly transparent. Why are you collecting data. What is the data going to do what role can I play and keep being transparent and keep sharing, even if nobody shows up when you do. Because people know that you're doing it and eventually people come and join. But, you know, I think there are many amazing lessons to be learned from the way acts and from the chism legacy work and, you know, and even the work that groups like elevate and others are doing around the country. Right. You've got to build trust in that work. I believe we have a question from online. Correct. Sorry, Dr. and we can't really hear you that well. Okay. Thank you. This was a great talk, Ruth and I really appreciated the insight that you shared with us today. A question regarding the current state of the housing crisis today. Given your extensive work throughout the years. What do you see as some of the challenges that the country is facing with this housing crisis, new families trying to start a family looking for homes, and even the homes that are affordable were built prior to 1978. How can a home buyer be confident that it's led free. If it's built night before 1978 the realtor says we painted over it. But is that enough information just food for thought. Well, I would say, I was on that issue right on lead. I'm really proud of the state of Maryland. Because the state of Maryland has said any bit for rental housing and that has now kind of moved over into our real estate market as sort of a culture. I think that we are going to ensure right that we are having advocacy always to lower the dust clearance standards that we're doing with many others the PA, but every house will pass a dust test. It'll pass a visual inspection. And if that on a rental side, right, if that doesn't happen. And if, if at any point in time child has an elevation of blood level or there's chipping paint, right, or other issues that are causing paint to chip peel and flake, that we will automatically require that repair that we've made not following the law on lead on again on the rental side and illegal rental so you can't go to rent court and collect money. If you are not fully in compliance with the standards of the law. Right. And we get, you know, we incentivize to get houses to lead free when we can, which is a harder standard to really dig in and get that done. And we have really strict liability. We protect people in rent court in against retaliation. But we've really had these aggressive embrace of standards, which I think go beyond just let right. If you commit to standards in housing that are evidence based right around those things around health and safety, and you have the courage to enforce them. And you will see things like that $44.5 billion economic return but more importantly you'll see the likelihood of housing stability, the likelihood of reinvestment. And most of all you'll see that in attention in health in reading scores in long term earnings right and so that's what Lancaster General Hospital what they are doing, for example, in the 50 million of that money is on lead hazard lead abatement to make houses lead safe and lead free. That actually does not come back in actual health savings to the health system. So if you, if you reduce asthma, we can track that financially and that we can, there's actual dollar cash savings. When you invest in lead which you are investing in is life, the quality of life, long term health right moving away from kids and adults exposed to lead will have a 46% likelihood of early mortality, a 16% greater likelihood of cardiac arrest, higher rates of hypertension, all of things that we know burden already burden communities. So it's, it's the ability to have the standards, the ability to understand what is prevention versus secondary prevention so prevention is take the hazard out of the house, remove the exposure secondary prevention is testing really important. So we know where problems are, but where you have data follow the data and take the action. It's much harder to do in the homeowner side because there's harder ways to enforce that. And I do think that every house sold in America built before 78 should have to pass a lead dust clearance test and a visual standard. And I think it would be better for us if we did it. But we do fight still today the concept of property owner rights about whether I'm going to do something. We have had disclosure law in the United States. It can be argued as the encouraging people to be like an ostrich and put their head in the sand and paint over it and say they don't know and back away. And we have problems, but we have to be diligent also to make sure HUD Fannie Mae Freddie Mac, all of these federally owned insured and backed properties that we are not putting those on the market, right. The federal control from federal and state dollars has to have a standard because that's representing us. Right. And the last thing we want to do, right, is to like, say, you know, family buys a house off the HUD list, and then their poison their child is poisoned so we use HUD money to go clean it up after they get poisoned. Let's clean it up before that happens always right. So I don't know if I answered your question entirely but we still have a long way to go in this country with as much success as we've had on issues like lead. And we can't do it with both without two things right community trust and the evidence right and those two things get you past most reasonable legislatures. We do have some problems with some that won't be reasonable right now but maybe we'll change those. Thank you. That wasn't a question I don't. Dr Middle said, please. I always have a question. Yeah, thank you, Ruth. There's excellent talk and I want to just try to drill into your legislative expertise and policy reform because that is the engine that we need I would argue we have substantial amounts of evidence and overwhelming amounts of evidence to take action right. I guess my question would be so as an example CDC's budget as you know for their asthma control program varies between 20 and 24 million they've had anywhere between 8 to 10% increases over the last 20 years of even having that program. Meanwhile, you know you look up the pharma revenue from asthma control medications and it's about 40 billion a year. Right. Our substantial disinvestment under investment in primary prevention or secondary prevention has has gone on over 20 to 25 years while the evidence and ROI is more than well established. So that's not enough. What is it what are we not doing what is the legislative strategy. I would love to hear your thoughts on that because I certainly don't know the answer. I know I keep every time I hear things like this I'm like okay I should give up what I'm doing and concentrate on that right because we'll first of all we need more people concentrating on these things because you're 100% right the evidence is there. But I would say in in changing legislative behavior on budgets. And I would also like to make sure that we understand some of that it is will be it will help build success of things that they want and believe in. And one thing I think that we must do as advocates is do a better job of building champions, like real champions at every level, not give up on any person. Whether it's a political party or not I know that's hard in this day and age. But find the reason that they may want to support something and I got, you know, I gotta tell you that all of the climate investments that we're making we need to purify a house, decarbonize a house. It can't happen when the house has the things that are sending kids to the emergency room for asthma. Right. We have got to address the issues of mold. We've got to address pest management we've got to address very poor indoor air quality, because if we don't do that. We have to stop all of those electrification jobs it will stop if we don't fix the roofs of houses in America. We can't put solar on them. Right. And so, making those investments in health actually strengthen things and we have to find a new way to talk about it. In terms of how do we, how does that investment build the success of other programs. And, you know, it's, I think in Congress, CDC is harder because it's not seen as direct investment. It's seen as surveillance is seen as science which is always up for whatever reason up for debate. And we have to make it more concrete in, in ways to do that but something we should talk about and continue to do because, and we have to put the focus there. I think we, we overlook CDC, because we're so focused on DOE we're so focused on HUD these big behemoth agencies. And again we've got to get to the things that make things work better. Good morning. So what was already mentioned that there's very little coverage of this topic within the scientific literature in terms and I've, you know, done a search recently looking at lead remediation, along with weatherization and that's pretty pretty much nonexistent. So my question for you is what I also have a general sense that those things are highly decoupled within policy. There's a lot of lead policy there's a lot of decarbonization policy. So if you were to develop kind of a policy agenda, or if you had it your way that you can attack these things simultaneously how would you kind of formulate this. Yep. And thank you by the way for the amazing amazing work of we act who I think should become the standard of everything we follow in many ways. So I think we are taking that approach that holistic healthy housing and the whole house approach is what we have to do right so we're we now have 14 states considering whole house, right, programs and policy and legislation. And it is, it works on outcomes right it works on data, it works on saving money. Right. And I always hate to say that because it's saving lives right that we need to do first saving money often talks louder. We have doubled down on the whole house strategy. Right, we have doubled down to talk to agencies that I know you know well like NYSERDA and say you have to be thinking about health in, or if you're the Connecticut Green Bank you have to be thinking about health and safety, but a whole house approach is every single time will prove out and I think we can move this at state legislatures in order to move the federal policy more. And DOE is starting to understand that under Secretary Grandholm, that you have to do this important, what they call pre weatherization work or pre development work. Well, that is all code for health and safety, right. And to do, but looking at the benefit of the whole house approach is big it's large. And that is the courage of common sense and the data bears out of the human stories bear out. So that is one. We need to expand things that how we do the funding we have a very small demonstration project that GHI worked with Congressman David price to get into HUD that is looking at how do you coordinate weatherization and lead, but it's only $5 million a year. And I just want to like on the issue of lead let's just get real that in June of 21, published this data of the 1.1 million lowest income families making $35,000 for household or less, who had imminent lead hazards in their home to clean that up is $170 billion investment needed. But the way that we have done all of the billions hundreds of billions around infrastructure and jobs and around inflation reduction act. Right. No money in that for lead based paint. Lead based paint and housing is still 84% of the problem of poisoning kids and damaging their brains. So we have a large case to make in that and the reason we've gone after whole house is because but we it's an opportunity to put the standards for lead eradication lead exposure and many other things that don't get direct funding like asthma is such an incredibly underfunded work on the intervention side. But if we can hold institutions to their word on social determinants of health and social drivers of health. Best of these things, right, but a whole house approach policy is what we are taking it's not doesn't that not trying to simplify it. There's lots to do in that. So all of the things we're doing, if we bring them together and align them grade them coordinate them right, we can, we can tell you what the gap is in funding. We can drive that gap through healthcare reinvestment through utility reinvestment and through some private sector. Kind of good guy and reinvestment in that makes the most sense for families we believe have a question online that I'll come back to I promise. And four minutes left but I this holistic approach right and whole house. I'm thinking also whole economy whole workforce development jobs right, we were having a lot of conversations yesterday with our planning committee and our speakers around these kind of forming issues with workforce development and training people to be able to take on these very important jobs right for weatherization decarbonization pre weatherization. What is your perspective on sort of how we're doing with the training the workforce, or preparing for what's to come and opportunities and jobs. The massive opportunity is, if you want to be an electrician or to be a plumber right it's thinking about electrification and decarbonization and and how do we incentivize people to want to be the craftsperson of being that contractor right and we talked about contractors as the new face of health care, because they're the ones on the frontline so doing a lot of this work. I think we are not hitting the market all on the contractor capacity piece. And that we need to find ways to do that. And one of the things that we have to do is in across the country, right, that are going to be the beneficiaries of so much of this work. We also have to open up their resources on apprenticeships on training facilities on opportunities. Much more broadly to black and brown communities across the country. Right, so that we don't have sort of people depending on workers of color to be at lower wage jobs less protected health wise right and we've been said that we are embracing people into the workforce to grow. So we have to, we have to grow that workforce by giving the right resources, and we have to build those things in community that stop people from being the owners of the company so in every community, the community foundations, Mayor should be thinking about how do we build an umbrella insurance ecosystem, so that we can lower that cost of entering the business how do we build a way to give money upfront for the capital to buy vans and tools and training right. And how do we open those opportunities to the higher wage jobs. And it's there right it's there for the taking, if people can access it, and if we support making sure that we have to remove the barriers to build the workforce. Right, and for all of you doing research by the way, everybody find a great contractor. We have a guy in our team, Brendan Brown, who was a carpenter in Orleans Katrina hit, and he decided after seeing that we need to go to the Bloomberg School of Public Health. Right, and has become a great researcher and capacity builder around. How do you put evidence into practice right so go find your local contractors. Well, we, it's going to be incumbent but it's also incumbent that we're building those community connectors those folks who can help really explain data, who can be a part of data collection and risk assessment. I look at jobs like risk assessors in the Baltimore community that will pay somewhere between 65 to $85,000 a year with health benefits. We have the mass amount of underemployed employed individuals who within three years could be at that skill that training and doing that work, and we need to go find that connection. All of us need to do that better is me and I know we are at time I'm just going to sneak in one quick question if you don't mind from online and we'll need to move on to our panel discussion. So, Mary Patrick online is asking in your whole house approach. How do you help people with multiple chemical sensitivity or has sort of your work addressed multiple chemical sensitivities let me make sure I'm also including your new homes are built with safe materials instead of cheap and safe materials. And I know you've addressed the sort of legislation issues but how do we get to new construction that's only done with non toxic materials. So, couple ways making sure your contractors are trained to recognize this super important that is on the scope of work right, and that as you are braiding the resources resources are also the human capital resources that may address asbestos who are specialized in doing that, and making sure that that's happening. Right. I, this idea of how do we change the standards of materials. I will say the healthy buildings network, the work they're doing is just amazing. And Jena should be maybe your speaker next year on this because she does such amazing work. But I was at a conference of mayors meeting, many years ago and the President of Walmart got up and spoke. It was being honored for at Walmart leading the way on the adoption of led lights in America. And they just decided to move off of CFL's LEDs that they completely changed the marketplace right. We have to convince the Walmart's the home depots the lows of the world that selling those products is the right thing so we have to get to that supply chain issue. And we have to build the case with them and we have to be talking to that those entities. Regardless of what anybody may or may not think about them as a whole, they move the market. Right. They are where the contractors are getting the materials. We have to work to make them price competitive and we have to get legislatures to really say, and this is I believe deeply in the power of the purse of the federal state and local agencies, they can set the standard. And I can say, if you're going to take our money won't replace a gas stove with a gas stove. Right. You will change that you will use materials that are less toxic, right. But, you know, so it goes everywhere from the contractor training, how you're funding that scope, but we've got to change supply marketplace. Yeah, that viable. And then we can talk with three more hours I'm sure we really appreciate your time. Thank you for being with us. A round of applause everyone. We are going to take one minute to transition to our next panel. Thank you so much everyone please stay with us. And I would like to take the time to invite. To the middle said to please join us on the podium here. We have Dr. Heather Stapleton who will be joining us virtually. And we have Dr. Alison. We all. Thank you so much. Can you. Yeah. Sorry, we disconnected a little bit so I'm just going to repeat that we have Dr. Alison Carter who's also on our planning committee. Thank you so much. Thank you for joining us virtually as well. Please give us one minute and we will move into our final session, which is our committee panel on next steps forward. So welcome everyone and thank you so much for joining us for this final panel conversation. Thank you for all my extreme gratitude and thank you to Dr. Glenn middle said, Dr. Alison Carter Dr Heather Stapleton and the whole team for organizing this wonderful workshop. We've had a lot of interesting conversations and talks from our speakers over the last two days. We also have online participation we would like to invite you all to please join the conversation and help us to think about next steps and going forward. And perhaps what I'd love to do actually is give Dr Carter an opportunity to, you know, reflect with us on her thoughts on some of the major themes let's say, of these two days and knowing that you've been working very diligently behind the scenes. Thank you again so much to help us sort of think through how do we bring this vision forward. Thank you Rema. I'm hopeful that you can hear me. Yes, and if you don't mind just speaking more into the microphone if possible I know I've been having some audio issues. Thank you. I've really appreciated the range of presentations over the last few days and I know both of you and and Heather worked really hard to bring in some great speakers. I think we've learned a lot and throughout the course of the workshop. We've shared notes I think on things that might be emerging topics that came up across presentations. And maybe also some observations that that we've had as we've put this workshop together. I think I can summarize a few themes that came to mind and then maybe see what makes sense to pursue as conversation. In no particular order but I think four or five themes came to mind as I've been listening and you know one is scale. I think rightly so there's been some great examples of how this work gets done models or templates of how others would like to address health in housing. And particularly around the products that are brought into those homes that contribute to chemical exposures, as well as sort of this, the systemic structural features of homes that that lead to long lasting exposures that are harmful to health. I think as the issue of scalability or, or taking a model and replicating it has come up. I think there's also been some really interesting discussion around what motivates that drive for scale and whether scaling is something that's warranted so I think that's something we could have a discussion around what kinds of activities maybe warrant scaling, which ones don't and what criteria might inform a decision to try to take things to scale or not. I think something else that's come up across multiple perspective or multiple presentations has been. What are the hard to reach perspectives and I think that's varied with the presentation sometimes it's the households or families that are maybe more difficult to reach or have been harder to engage with. But I also think there's been a few presentations that have highlighted. Maybe the lack of insight we have on perspectives, say from contractors or insurers. And so thinking about what barriers maybe limit involvement of those hard to reach perspectives could be a thread for discussion here. A third theme that I think has been very pervasive is the idea of governance. There's been discussion around standardization certification regulation, who makes decisions in the indoor environment, it varies by who lives there and who owns a property. Timing of decisions when our decisions made especially those that are less reversible or maybe even irreversible. So maybe thinking about as a group what are what have been some examples of good governance for indoor spaces what would good governance look like. It seems unlikely that you know regulation of indoor air would look like regulation of outdoor air but maybe thinking about what those models would look like if we if we tried to standardize and regulate spaces where people have historically experienced really harmful exposures. Maybe I'll, I'll, and I'll raise just two more is that okay we mind Gillian, I don't want to drone on the other topic that or other theme I think that has arisen as I've been listening is that of complexity. Indoor chemistry has been referred to as complex indoor environments have been referred to as complex and then solutions have been referred to as complex I think a few people. I'm Gillian and Paul come to mind I'm sure there were others have mentioned that you know if we were to walk into a home and not come away with 50 to 100 things that could be improved then maybe we're not looking closely enough but that. It's a fairly complex set of solutions then to address harmful exposures and indoor environments and so I think what's come to my mind is maybe a somewhat. It's probably not that radical but it feels radical to say like what if we never took another measurement. What is the role of measurement moving forward. I would suggest we don't need it but what needs to be measured and what doesn't need to be measured what do we know enough about to move forward with solutions. And then a final theme that seems to come up repeatedly is who does the work. I think Ruth Ann was really, you know, much more eloquently than me commenting on to the need for scaling the practice of building and ensuring healthy housing. I know Paul so reference these topics and so did others. So that kind of work who's doing that work how do we build capacity there. I think I'm also curious about the diversity of experiences that people have had in communities where you know including my own experiences where in some communities. Members have really wanted to be engaged in the work of learning about their environment interpreting data developing solutions and in other cases that's not been where people's interest has has been. And, and I think that heterogeneity is, is okay I think maybe trying to understand how to gauge that level of involvement, and then how to, you know, accommodate changes in that level involvement so thinking about who does the work and how partners have engaged successfully over time in learning what the level of resident involvement may need to be or what's desired. So those are some of the reflections that I've had over the last I guess day and, and a little bit. Maybe I'll turn it back to you Rima to see or Gillian to see how you'd like to proceed with the conversation. Also happy to revisit any of those if helpful. That's Dr Carter. Dr middle. I, you know, I just appreciate I thought. Alison. Have any online specifically I want to just I have some summative thoughts as well but I want to first to see anyone here in the room, or anyone online in response to the excellent summary that was just provided. I was actually not not texting with a friend as texting a colleague asking for her questions and I will say so she has been a trainer for my organization for now. She's a general contractor by trade. She is an architect by training and she helped build the American Lung Association's healthy homes assessment program. So, you know, almost hitting every point that you would need to be and she's an outstanding trainer. But she has also noticed that you can have your train she trains hundreds of people effectively, but without the policies and legislation. There isn't going to be a requirement to put in a higher level of standards for retrofits and upgrades right or she or there may not be for new construction. And I will say if she were here the other thing she would say as she has worked for years with the green building movement. And it's fantastic that we have lead certified buildings in green building and energy star. But have you ever looked to see how many of those are applied in low income housing right EPA's indoor air plus is an outstanding program as well. It's really painful I think for both of us to see middle and upper income especially upper income homes, built green and highlighted and they're this shining standard. I don't think they have set the ball rolling down the hill. I think they just now happened to live in an incredibly contaminant free well ventilated home. So I'm just wanted to share something about her experience and thoughts. Thank you so much doctor. Audience online. A chair to to discuss and perhaps going back to the issue of scale it's fascinating to me. We need to have some these circular ideas sometimes right is well how do we get there we need to scale up. Maybe we don't write ball but you know to do that we need to train the workforce we need to change business models to kind of create the demand for these holistic approaches we need to create jobs we need to provide the evidence and the data and the science. And then again I keep going back to the sort of disconnect between it feels and in my world that is where I sit, you know, day to day in the research and getting to implementation and practice right. I feel like we're missing that link to make a real dense and scale things up that way. We need to provide an opportunity for Dr. Neon. So please chime in. Thank you Rima. I had a question about the report. Going back to the report. Thank you for that question. Dr. Carter, did you hear that question. Would you like me to repeat it perhaps. Yeah, would you mind repeating it. I heard part of it. But not the whole thing. So. As being an integral part of writing the report and putting it together. How do you think this report has helped move the needle in the space. And what do you think could be done. Further. Thank you for that question. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Yeah, would you mind repeating it? I heard part of it. But not the whole thing. I think it was really for the committee. And the, you know, study members that worked on this report. You know, how has it's impact been. Especially the focus on environmental justice with it. You know, why did you choose to work on this report? And how have you seen it sort of have an impact in this space. And I think that's a great question. And I think that was honestly. Very encouraged by just seeing it referenced so many times in my, let's say, scientific circles. With Dr. Miriam diamond at another meeting actually. With Dr. Dotson stock with so many talks in this space. Again, I feel like the issue of the indoor environment and indoor air has been so. Relative to outdoor air and the conversation there. That this report has really helped kind of bring it back to the forefront. Perhaps it was well timed during COVID and all that increased attention. And I know the work of all our speakers in that space. That really helped kind of catapult this forward. But I also feel like, you know, our committee coming together to really put our brains together and review this evidence. And I think that the challenge was to really think about indoor chemistry. Right. And even using the word chemistry sometimes can be scary. To the general public. And I. You know, from my perspective, I've said this multiple times. Sometimes we talk about chemicals. And that implies risk. Right. But that's not necessarily true because a chemical is a chemical. That's just what it is. Right. So we have a lot of human exposures and disparate exposures. That we really brought out in the exposure chapter that Dr. Carter led. And environmental justice concerns and how that leads to health risks. In the general population, but also in disproportionately sort of burdened communities. I think we really did a great job in sort of integrating the industry understanding of the complexity. Right. So to me, that's what I'm very proud of and obviously learning from my colleagues is that we sort of went from deep down chemistry and analytical issues. And sources and complexity to human exposures and health risks. And a path forward and a vision forward for this field and the space and why we need it. And I'm actually proud of these dissemination workshops that we're working on. I'd love to give my colleagues an opportunity to chime in. I appreciate what you're saying. I think it's, it's a great question. Two responses. One is that it highlighted that the indoor air chemistry indoor air field in academia and healthy homes practitioners are not as integrated as we could be. Right. So we, there's those doing field work and research and publication and interventions. And I was surprised during the development of the report. How much I would learn and I thought I'd read the literature, but I didn't really understand where the trends and themes were in the research community. And I think vice versa in the healthy homes and which is why I appreciated being able to invite several of the speakers who are here today. Because I did want. You see in the literature, the gaps in understanding about real world conditions sometimes and not from anyone published in this unit, I'm saying, but you do see it and you can't adequately characterize indoor air chemistry. If you don't see the overcrowding a home where you step through the floor because the mold is so significant. You know, just roofs without pieces on them. Like those need to be measured just as much. So I think that's just my, oh, the other thing I was going to say is going forward with this report. The indoor airfield. I've worked in it since I personally was in a building that was contend. And I was made very sick premature pregnancy along with all the other women. And that's how I ended up in the field. I don't think that we can go. I don't think that we can go forward right now as far as we've come that the question of what if we took no more measurements. Like that data is so important for EPA and Congress to move forward. But do we need like partitioning was fascinating to me and understanding that and that will help with regulation of chemicals. But I also feel like. We're working on the tracks and there's a massive train coming, which is the climate events, the heat and the weather. And we're working on the tracks and collecting our data and efficacy. And this train is coming. We're about to have a massive destabilization of society, our economy and potentially our food systems. And yet now of a sudden we do have money to do. Cooling some filtration. So while we're here working on the tracks and collecting our data on efficacy. And this train is coming. How are we going to graft ourselves on to that? That report is one way of saying, thank you. Thank you. Well, please hold on to your question. Don't go away, but I just want to make sure Dr. Carter, did you want to add anything. From your personal perspective on the report. In response to Linda's question. I think, you know, both of you covered some of the greatest strengths I think of bringing the people together that. We're a part of forming that report. We're a part of forming that report. We're a part of forming that report. One thing that I had hoped for, and then I think. Did seem to come. To fruition. By. Permitting us. The opportunity to interpret our charge. Perhaps a bit more broadly. Then we. You know, needed to. So, you know, the way these reports. Are designed. There's a charge. That's the scope of what we will cover and also. Sets a boundary on what we won't cover. And I think. As a group. We. All wanted to see. Environmental justice intersect with indoor chemistry. And that. It isn't. You know, necessarily. One degree of freedom. And I think there was a lot of receptivity to. How can we bring these concepts together in a way that's still consistent with the charge? I think that. You know, was a positive experience for me and hopefully others. I think something else that came out of that because that was. An early decision to make this its own chapter. Is that I think. People from different realms of science saw the value of learning from other realms of science. So. Learning about interventions. Can indeed be informed by understanding. Partitioning. In certain contexts. And at the same time interpreting. Complex indoor chemical data can really be informed by understanding people and what makes them. You know, act the way they do in their homes. And I think. Being able to work on. Those intersections for, you know, quite some time and, and assess. Evidence from. These diverse realms of science. I think also. Put, put that those pieces of evidence on a. Similar level with one another. And I think that was a really valuable outcome. Hopefully that has come through in the report. That'll be for. Those that use it to decide. Thanks. I'm much doctor Carter. Please call Francisco question. Thank you. I'm not sure if this is a question or a comment. Inviting reflection. But so this session right now is really about next steps forward. And. I'm kind of wondering next steps for what. For whom. Are the next steps for research and researchers. Are the next steps for outcomes for residents. You've talked about scaling. You've talked about it. You've talked about it. You've talked about it. You've talked about it. Honestly, I think that. Scaling of research is not what we need to do. Just doing the same project in a hundred different places with a hundred different researchers is not. It stops being research. But. Broadening and expanding research. There's still a whole lot of questions. We don't know. So is it next steps forward for broadening and expanding research. So. And now comes. To these EJ communities that this workshop is about. If that's the case. Then in a lot of ways. There's a lot of things we already know enough about. And it's time to start doing things. Stop researching it and start doing it. And so then. What is our role. In doing that in. In giving the information to others who can use it. And helping to establish regulations policies. Programs. And. We're never. The research community is never going to be able to serve all the needs for that. We have to give it away to other people to do it. So is it next steps for that? What are the next steps for. Very much Paul. I just want to say that I deeply appreciate what you're saying. I think it's sort of a, an excellent point in time question to ask in our field. I didn't finish it, but there was the book by and about Dr. Paul farmer mountains to mountains. Not sure if any of you have read it. But one of his quotes that I kept on my wall for a while is. He was attacked by kind of the press and agencies at one point, international aid agencies for saying something somewhat similar. He said, I just said, we have the data. So now what? You know, his point was. You know, I want to just to keep collecting data because we can, but we're at a point where we can use this. Not just implementation, but to actual have systems change. So you don't have to implement intervention. Means there's already a problem. Right? So the idea that we keep developing interventions is, so I think it's, it's poignant and a fundamental question that you've. You framed here. I just want to add to that. I mean, I completely agree with you. And that's kind of what I'm taking away from these two days of our conversations. Right. I definitely think, you know, research and science are very important. And there are questions that we still don't have good answers to, or like the example Dr. Carter gave about how. Just understanding partitioning behavior itself might really lead us to figure out more effective interventions to do things. Like I said, I do really feel like there's this big gap between sort of the research community and the practitioner community. And I honestly like completely honestly did not realize this before this workshop. And that's why I'm so happy to always be learning. I do feel like we need the path forward needs to be exactly what you're talking about. Dr. Middle said, and how do we make a dense. Interventions and changing outcomes on the ground. Right. So I feel there's this great push in the research community to be more kind of solutions oriented and, you know, intervention focused. And that is great. But it's also sort of not everyone's skill set in a way, right. So I feel like there's just a little bit of a disconnect between. You know, just the conversation of what is that science that you need to be most impactful in your work. Right. And going back to the research community and educating them as well. You know, on sort of how can you broaden your horizons to be more connected to the real world problems and make it dent and things. I was getting a little bit philosophical side. I apologize for that, but I do really struggle with that idea. Even what we were discussing with sort of community engagement models and frameworks to do things we heard from amazing speakers who are all experts in the space, right. But even the words community engagement in sort of a practice type of setting are different from in a research study and the funding models are very different. And so that's a little bit where I feel the pain points are and where this conversation is really helpful for us to bridge these gaps. Paul, please. Thank you. So you made the comment that there's a big gap between the researchers and practitioners. And I completely agree. And that's one of the things I've tried to do is, is be that be a bridge in this space. Doing that in part by training a lot of practitioners. But I'm also, I have a job that lets me do that. I think one of the problems is we, in my talk yesterday, I talked about, we have to value communities. We also have to value the researchers and give them incentive to do this work. In my opinion. Very few of you know, it's usually time to do this work and give them incentive to do this work. In my opinion, very few researchers are incentivized to connect with the practitioner. If you don't have an incentive to do it, if it's not valued by the organizations you're working for in the systems you work in, you're not going to do it because that's taking away from doing things like new research, students, papers, things like that. to knowledge generation, which is I think what research is about, to knowledge transfer, which is not what research is about. We have to empower and incentivize researchers to start engaging in knowledge transfer. I gave some examples of how would you value communities? How could you be valued like reference letters from community leaders? Maybe if it your faculty, maybe you can swap out a semester of teaching college students for a semester of teaching practitioners and have it be equally valued. I don't know if that's the right answer, but I really do think if we have a role in the knowledge transfer, we have to be incentivized to do that. And if we don't have a role in the knowledge transfer, we got to figure out somebody else to do it because it's only going to scale for solutions if that knowledge is transferred. 100% agree. And I do think that's a fundamental problem and maybe take a semester off and not teach practitioners, but go learn from practitioners, right? Linda, if you don't mind, we need a charger for the laptop. Thank you. And I'll go to the online questions in a minute. But sorry, before we go to Dr. Dotson's question, did you want to comment on this? Dr. Minnell said or Dr. Carter. I will just say my colleague is, yes, she said, you know, invite researchers bring them out into the field, she said out of the office and into a crawl space. But I will say that the other massive piece who is not in the field is the federal agency staff. If you've ever noticed when we invite them out, they come out for a field trip once every two to three years, and maybe see two or three houses. They don't see the conditions and we just did a massive health fair for communities impacted heavily. And they brought a PowerPoint and you can't bring our point to a community that's acted by smoke and pesticides spraying and poverty and rural dust, you know, and it was, and they're very well intended. But the point is, is they thought that you were going to have sort of a professional forum, right, as opposed to engaging just with our community. So that's great. Dr. Carter, did you want to add anything? I think I just want to affirm Paul's comment is, if we think about next steps, it needs, we need to be specific about next steps for whom and that doesn't mean one group at the exclusion of another but I think that if we're speaking from a researcher perspective, I do firmly believe there are some very high systemic barriers in academia to aligning the work that needs to be done. If we want to do work for people with the incentives that that engage researchers in the process to begin with. So, I think it does actually connect to a question that's online but we can come back to that. Dr. Dawson has a question. I think there's a question about building relationships and longevity, particularly for your early trainees so maybe we can come back to that after the in person question. Thank you Dr. Carter and thanks for saying that actually if you don't mind we're going to need your help moderating some of the online questions because our laptop here died so we're going to help come back to you. Yes, and I want to tell our online audience we are seeing your questions and we're going to get to them for sure please just bear with us a few more minutes. We'd love to hear from Dr. Dotson in the room. Thank you. Thank you yes so I'm sitting here kind of thinking about why I do the research I do. I have a couple of thoughts, and I'm thinking about how I do this research to characterize what's actually happening indoors. How I think it's really important that, and I think something actually the report did very well is this acknowledgement of like you can have a perfectly built indoor space, but then you introduce a person and things get really complicated. And that I think is super important we can't think of things as static. And how we can take that information about what we know from our research and inform practitioners and and and help communities. And I see that as kind of trickling that information downstream, which I think is hugely important to have an impact. But I also want to put forward that I think as researchers we need to also think about how our research actually should go back upstream and have the impact that we can have wonderful programs that you know like Paul leads and GHI leads and I think those are wonderful of getting into homes and and figuring out what's going on in homes. And those are hugely important, but people can only do so much. Still, they have no option but to bring in toxic products into their environment, or when we go in and we do all this rehab work and we put down vinyl flooring everywhere because it's highly resilient. And we're not thinking about the fact that we just introduced a whole suite of other contaminants into the home. Yes, we've addressed some other really important things like lead and pesticides. But, wow, we've just introduced flame retardants and phthalates and a suite of other things PFAS things like that. So, anyways, I think that what I guess what I'm trying to put out there is I think as researchers we need to think about implementation. We need to think about how we translate to practitioners and into communities, but we also need to do our research in a good in a space where we're thinking about how it can actually inform and gather the evidence that's needed to go back upstream. What are the things that need to happen in the, say the building certification programs around material safety. What are the things that need to happen around even just the cleaning product industry and what chemicals can be used in cleaning products. What about all the furnishings, what about all the personal care products that we're bringing into homes. If those are toxic, they will contaminate the indoor environment. So I think that we need to think about the regulatory and the policy levers upstream, in addition to the downstream, you know, implementation. Well said. Yes, thank you so much Dr. Dotson. I think you said it perfectly and I'm not sure I have an answer for you but I do appreciate you kind of sharing your insights with us. Dr. Carter, do you mind helping us with some of the online questions. Sure. I'm happy to help there are a number that have come in. I'm trying to summarize there's a few that have some overlapping themes, but maybe to pick up on the. I think something that would be applicable to a range of people listening in is a question from Colin Bremer that asks what advice would maybe panelists and speakers have for graduate students or postdocs. I would like to break into this space, but may not be in a place long enough to build the kind of relationships that we've been referring to here or maybe limited in their ability to allocate their time. I'm paraphrasing here a bit, given the high priority on publishing in order to complete their degree program and have a competitive faculty application. I would like to maybe expand the question a bit beyond just graduate students and postdocs and early trainees and maybe say, you know, for those that are not necessarily in a position or feel like they're in a position to build those long term relationships. What might be some strategies or what what have people done in order to sustain relationships, even when the level of commitment is buried over time. So I think there are multiple people in the room, including, you know, both of you that could maybe respond. So happy to turn the mic over. Thank you Dr Carter and if the panel doesn't mind I'd love to just share some thoughts on this because I really do appreciate this question. And I see it a lot with a lot of our trainees and in my personal sort of professional journey. I do think that's another systemic barrier right and the way sort of our education models are built. We have been encouraging and we've been having these conversations with Dr Fabian to yesterday. You know my students or prospective students wanting to join programs to really look for those interdisciplinary programs. I'm not minimizing the importance of depth in your field, but we're in a day and age. Thank you. It's really important as a scientist to be very good at your field let's say or really understand sort of the depth of the topic you're in but to also know how to talk to other scientists and practice and translation and all that so I do think some of the most wicked problems of our days and if you guys know this reference it's really sort of for the need for trans disciplinary science and research right. We use these words very lightly or interchangeably but they mean different things right, going from multi disciplinary to interdisciplinary to trans disciplinary now right. I think our educational systems are perhaps catching up and there are some great examples out there, but really putting students and very inner or multi or trans disciplinary settings where you can get your PhD or your early career training in this topic you're really passionate about but also learn to hear from and interact with and talk to other disciplines and understand how the language you use is perhaps not the same as the language. They use but there's a common core to everything we're trying to do here. And so, so that that's one of my thoughts on sort of how to balance all this and I think, you know, it doesn't necessarily come with a laid out program per se but some of it could be individual sort of, drive or trying to pursue these kinds of training opportunities. Maybe that's enough I had more thoughts and perhaps but I do see Paul and Dr Fabia in the room so please chime in. Thank you. So I have kind of three thoughts on how to help promote. How about this. Okay. It probably gets higher but I don't know. So three thoughts on things that students can do to build some of these connections one, go to a practitioner conference. The HPC home performance conference every year the next one's in April in Minneapolis 2500 2500 practitioners talking for most of a week on a whole range of building science healthy homes. Brazilian electrification all kinds of stuff. Go there and learn go to everything you possibly can and learn from the people who are doing this every day. It's, yeah, it's a few days, but it's only a few days and an entire graduate program. There are some like from the building performance Institute there are knowledge certificates you get a you get a certificate. It's like 250 bucks for the book in the exam go through and learn about building science learn about healthy homes principles. Again it's a little time but it's only a little bit of time in the context of an entire graduate program. The third would be find your local weatherization program. DOE's funded weatherization program serves every county in the United States and find the local one and see if they let you shadow them for a few days and see the work that they're doing in the housing that they're doing it. I don't know that they'd be willing to have you shadow them, but ask is they are going into houses every day, trying to figure out how to solve the problems we're talking about and they're specifically working in these communities. Thank you. Thank you so much, Paul. And actually, if folks don't mind indulging me before we go to Dr Fabian's question. The part two of what I was trying to say is that sometimes it feels like science and academia are very sort of individual focused, you know your career track and your success and so on and so forth. And I feel like there's a lot of emotions and all this whereas really we work in teams now and I feel like you know there's this reactionary kind of fence in the field of no you need to be doing this no you need to be doing that no now you need to be like an implementation to be doing community engagement and the reality is, none of us are all these things combined right. I learned from my colleague Dr Jill Johnson who's an expert in community engagement. Every day I'm not the expert right, but I think other than transdisciplinary learning also learning how to actually do team science and a respectful kind of collaborative way. So that culture in our training programs in academia needs to change and evolve sort of with the times to get us there to even know how to do team science because at the end of the day to build and sustain these relationships. It's going to take a village and a team and not a single person can sort of be all those skill sets or be good at doing all these things. That's fine. This is my personal opinion I have to say, not an Academy's standpoint right but I do think this is like the underlying, you know, challenge and a lot of these conversations. Dr Fabia. Thank you Dr have I just wanted to actually build on what you were saying and offer some practical advice. I offer my trainees and then for the postdocs or sort of early scientists on the call. And that is a community engagement doesn't start when you start a research project, and you can do community engagement, even if you're in a transitional phase such as a postdoc or a doctoral student, because community is where you live. And there's environmental justice communities everywhere that you live. And there's lots of opportunities to engage if what you're interested as an education sustainability. There's all the energy sustainability committees that towns have. You can be part of a committee you can just attend the public meetings, and then you get a sense of what people care about what they're talking about, start to learn the language and how to try to connect all the science jargon language that you have with language that people might understand or want to hear about beyond sort of what you think is important in your research. So I think if community engagement is part of one of your goals that doing that at the smaller scale of doing it in your community and just attending meetings that's a pretty low task committees meet once a month, if I think about my town committees, you can just sit there and kind of listen to what people care about. And then once you sort of move into something that's more permanent, and you need to build relationships that are around community engaged research project where you will be in the community, you know, being there in person, etc. You've actually sort of built all those skills along the way, and set yourself up to be more successful. Thank you very much. I'm sure her junior trainees and attendees really appreciate this advice. I have something to add to this conversation so we use a lot of graduate students when we do our pilot field work and, you know, we might be setting up a network of purple air sensors, which is probably the most common thing we might be doing or distributing our tool kits to households and we will use them mostly on the air quality scientific side to help with collection of data. But it's such a win-win because they get work in the field and they're out there and then they go on to and we also tend to introduce them to then the state and local agencies in the community groups that we work with. And I will say that at least two interns in academia who we have used, I believe, are now working at our Department of Health. So instead of going into academia and not that I'm advocating for that, but that they saw a different pathway to apply their training. I just have to add one other thing. So we're talking about ways to get researchers out into the field and hearing the real barriers that we don't understand in academia to that. I was talking about federal agencies getting out into the field, but the other big piece that's not in the field is have you ever seen a physician or a clinician in the field? We have community health workers and community health aides and promotores, which is fantastic. But you know the number of clinicians I talked to who truly don't grasp what an environmental exposure might look like on a daily basis in someone's home and therefore don't treat their patient for it to me is a massive gap in our system, because if you are not being told by your health care provider that you are exposed in your home to something that your health conditions could be mitigated by retrofits in your home. Are you really going to believe it maybe? But right now we still have this sort of heavy lean in our society towards if my doctor isn't going to validate this. Is it true? Right. So anyway, that's my two cents on that point. So much. Sorry, Dr. Carter, I can't tell if you could hear me or not. Today, if you have any thoughts, we welcome them. B, could you please help us moderate the next few questions from online? And I also see Dr. Diamond's hand up. Thank you. Yes, let me, because there have been a number of questions that have come in as much as I've actually loved to keep talking about engagement and ways for people to do this early in their career. Maybe it's something we can come back to if there's time. There have been a number of questions or comments that I think I'm going to synthesize as relating to perhaps regulation. You'll forgive me for those that have made these comments. If I've misrepresented your perspective, please follow up and I'll try to do better. But I think there have been a couple of comments related to specific hazards such as artificial turf or lead in products that are upcycled or recycled, lead containing building products that can be reintroduced to indoor environments through regulatory gaps. And so I think these, these comments and questions sort of intersect at the point of regulation and I know there were several people who gave great presentations. So Johnson's is coming to mind, but I know there were others related to pollution through broadly defined consumer products. And I don't know if we could spend a little time thinking about what does it look like to engage in particular with that sector, people who are making decisions about regulations or regulators themselves. And I think this connects with another comment by another audience member indicating like how do we, if we have the data that we need, how do we translate that into regulatory action. So I'm hoping that that's a fair synthesis. But I think that's the spirit of the comments and questions. Audience. That's that question. I'm thinking back to Ruth and comments to be honest and how sort of it all connects together right from markets and creating demand to providing policymakers with the cases they need to make that align with causes they care about sort of packaging that all up. I feel like the comment, Dr Carter that you communicated is is maybe perhaps more from a researcher perspective, but I think it's the theme that I'm seeing from all our conversations is really we need to be more integrated across these spaces and and these silos of how we even sync and function and operate within our organizations. You know, I know historically we've all been in these conversations or researchers worry about sort of the advocacy hat, right, versus the, I'm a scientist hat and I don't think we need to get into these conversations today but I'm really hopeful that with all the conversations that we've been having that researchers have some clear examples of how they can actually engage with their community boards with town halls with policymakers to push things along and we've seen great examples from all the speakers right. I do. So, perhaps, I don't know if you wanted to add anything to that I'm good and we've got Dr. Dotson and yes. So, perhaps if you don't mind Dr dots and give us one minute to go to Dr diamond online who has her hand up and then we'll go to an in room question. Thank you very much for the opportunity to contribute again. I have a couple of points and first of all, again congratulations on putting this together. The second point is that I think we should be very careful about calling for more research when more research isn't needed and in fact it's implementation as an editor I see this all the time. And it can be it can be it really can shoot us down, because we never seem satisfied to have a sufficient amount of information to move forward, so that certain elements can take that. We can run with it. I also as an editor I encourage all of us to avoid hyperbole. When we talk about the urgency of various issues. The second point I want to make. And this really follows up with the need for integrated research is the need to do research on solutions. What actually works. What strategies work what what, what solutions work so you see this more in the medical field with an with outcome based research of, for example with medical with medical policy. Show us the policies and figure out, you know what those outcomes are. So I think that's that's very, that's very potent. They, the parallel would be attribution science for climate change. I think we could take a attribution science has been really important in moving forward the climate change issue. Not far enough, but anyways. I think we could take lessons learned from other fields on what's on what's effective. My final point is what I made yesterday, even as I spoke too long. And, and Rima, it speaks to your comment about, should we be advocates. So I work, I work in an ecosystem. I work with non governmental organizations. I hear what I hear what they need. I support them in their work by giving them advice. I will be a talking head for them. If they want, I try to have a bit of a firewall so that I maintain my position. As a scientist, even though I'm short and a woman so that's like always a problem to establish authority, but anyways, knock on there. So I work with the media a lot. And they are my, they are my best friends. Well, they're not my best friends, but I work with them a lot because they're constantly having questions, and they're a great. It's a great connection to move this to move our science forward to make it publicly available. So those are my notes. If I were to redo my career, which is not happening, but anyways, I would focus more on solutions on what those actual solutions are, rather than ad nauseum of diagnosis. Let's just measure more. So, okay, thank you very much for this wonderful workshop. Thank you, Professor Diamond. It's just wonderful to hear your wisdom and I could not agree more and this is direct evidence to all our junior audience members to hear from the most successful researchers in the field on impact and career choices. And how you in your own role can be very effective and can support right this larger mission and can find your niche and how you can be, you know, a valuable contributor. Thank you so much, Dr. Dr. Miriam, very appreciative of your participation and your wisdom sharing these two days. Thank you so much. We have a question or a comment from Dr. Dotson in the audience, please go ahead. Yeah, I guess this is more of a comment. First of all, one of which Dr. Iman just said and it's another short scientist I understand that sometimes it's hard to get the attention but the point that she made about actually, you don't have to be the advocate but if you have partners who are you can do your research to support those and working closely with those people who do that very effectively. There are NGOs out there who's, you know, working very hard to implement those policies or change policies. And so talking to them figuring out what information they need. I also to get back to that earlier point to about how how to affect policy change. I think one way to do that perhaps is to actually design studies that are doing that explicitly right so we talk about solutions oriented research around mechanical interventions or something like that right but but what if the actual the research question is around the outcomes related to particular policy itself that would provide evidence that I'm sure lawmakers would sit up and listen to is if we tweak or if we if we redesign our studies slightly to be explicitly trying to address policy concerns or questions. So much and I do. You know I just want to highlight again the comment that Dr diamond had which is understand your role in the ecosystem and if you need to have that firewall so for you to be effective in the role that you do. That's fine right, but 100% you could be, you know, we all can't be everything right for each of us can't be everything. And I think that's important. I do. Perhaps we go to Dr Carter online because I know we have a great conversations online and some questions that are coming in that we can take and then we have some more thoughts. Thank you I do think that. Oh, a question that I'm, I think I overlooked earlier that are a comment that I would like to bring up because I think there are a number of people here who would have insight or reflections on this. Debbie Bennett posted a comment that one challenge in upgrading. They specify privately owned apartment buildings but maybe I'll take the liberty of expanding that you know upgrading properties in general may occur and coincide with an increase in rent. So retrofitted housing, which continues to be in demand and may increase in demand is costly and that costs can be passed on to the occupants to either cover the cost of the retrofit, as well as acknowledge the increased value of the home. And I know that there are a number of, again, people in the room who's already presented. Sometimes this is presented as a split incentive that if the retrofit is made, then the cost is passed on to the occupant, or instead the retrofit is not made because benefit is passed on to the to the occupant and not the person or property manager, making the investment. So I wonder if those in the room might speak to this split incentive or this difficulty in who pays and how those costs get passed around. And I know, I think with Anne was mentioning work and somebody yesterday I apologize I don't remember who is mentioning work on sort of mitigating this risk. And maybe there are some other perspectives that that I'm not having come to mind. Sorry. And Paul, if you have any, too. It's an incredibly significant question because it's a force that happens in any of the communities that were have been impacted for 4050 60 years by redlining that are gentrified, right. So when the retrofits and upgrades, and then that drives out those who make a living wage and it drives out the communities of color. So I think you've, whoever pose that has raised a spot on question. And I don't know. And one of the things we see in our work quite a bit is that people who go bought who are able to buy a home and become a homeowner even at the lower income level. They're often buying a home with a legacy of substandard issues. And then so they might be able to afford barely the heating and the energy cost operate that house and to pay the mortgage, but to actually do the retrofits and upgrades themselves. They don't end the list could be very, very long as the amount of work that needs to be done to that house so that would just be my observation to that. A couple of thoughts. One is this is sometimes where programs can come in, you know, do is weatherization program. They do work on rental housing they require that the benefits convey to the residents, but because the program is paying the well, oftentimes there has to be some amount put in by the landlord by the property owner. But of course it's going to be just a fraction of what they would have to do to do it themselves. They do get a significant improvement to their property for a fraction of the cost. And because the benefits have to convey to the resident often it comes with like for the next two or three years you can't raise their rent. So that would directly address that so to the extent the programs can be leveraged to address some of this issue I think it's good. I think another thing that I don't know if there probably has been research done on this I've heard about this issue I don't know how well it's been studied is just when you have better better rental housing, you have less turnover. And there's a big cost to finding a new tenant, because the last one left, and where you have greater retention of tenants because they're happier with the building they feel better in the building they're healthier in the building. There are just savings there that could at least partly justify those expenses it's like I said I don't know what degree of research there has been but I've certainly heard about that being something that there have their landlords that have done interventions to try to make healthier buildings that have been seen increased retention of tenants. And that's been part of their business case whether it actually pans out I don't know. I'm Dr Debbie Bennett. I just got a couple comments to that. One is that this is in some ways a short term problem. Right, we have a goal to get to net zero by 2050 most states have that are a lot of states have that reductions in fossil fuel emissions by 2030 specifically I can talk more about Massachusetts because that's where I live. And it means that all homes will be electrified by that. So it's not a goal that we're working towards in 100 years or 200 years or just in general the way that we've been working so far with weatherization programs. So it's a short term problem to solve. So things like the Massachusetts Clean Air Center, they're trying to figure out how to incentivize landlords incentivize apartment owners. You know, a fund of money for triple decors right now for example, trying to figure out how to decarbonize homes and get to electrification. And part of that conversation is okay then how do you get the rent not to increase etc. But maybe just returning to the fact that doing something like rent control and for a very short period of time when those retrofits happen that could be a solution for then all the homes will be retrofitted pretty soon. Right. Theoretically, that's kind of what our thoughts. So anyway just wanted to point out that it's this unique point in time where we're all racing to get to electrification and all these things about who pays for what have to be both solved quickly and can be solved with short term policies because we'll be there by 2030. Okay, I don't know if I said this any conversation last night at dinner or yesterday but I want to caution when we use the drive for electrification because even that in and of itself is a little bit of a. It's absolutely fundamental from an ecological perspective, but using the term is also sort of progressive educated. Much of the West Coast rural communities cold climate communities tribal communities are already electrified that's all they've had. They have not had gas they've had maybe some propane. So but so that isn't driving electrification isn't a major issue. It's air sealing insulation, weather is other weatherization factors, reducing a wood burning appliance that's used in the front room with wall heaters in the back so you have a massive temperature differential, you got PM in the main room and mold throughout the back rooms so it's you know and their energy costs have been somewhat lower in some places because high affordable hydroelectric power, but they also see significant changes I just want to say electrification. Thank you so much for that perspective and Dr Carter if you don't mind just a couple of thoughts from in the room and then we'll go to you as well. So we did also want to ask the audience these few questions and we would love to hear from all of you. Before I ask you these questions I also want to quote Dr diamond by saying perhaps we need to use the word allies for scientists, meaning allies of NGOs, media groups of practitioners etc. If you are a scientist kind of thinking of how you fit into this whole ecosystem you could be a very powerful ally in this mission. Some questions that we had for the audience that we'd love to hear from you on before we go to Dr Carter. What key messages did you take away from this workshop and what did you perhaps hear from yesterday's discussions and today's discussions that might have surprised you. What are your thoughts on how indoor air should be governed, if any, please think about these questions and chime in we'd love to hear from you. And feel free to use the raise hand feature and we can spotlight you, but Dr Carter. So, I, I've been trying to look through the q amp a and I think another comment that came up that maybe overlaps with some conversations but I did want to highlight from Mary Patrick was provided a number of interesting comments and questions. Environmental justice requires action. And that we've seen the need for data is great. The question is how do we translate the research to education and then action, which has come up a number of times, but I think in particular. This comment that she left that says environmental justice means telling the funders it is time to ship the money from research to addressing indoor air quality and building healthy housing in school so I do think. Maybe I'm revisiting this because I think Dr diamond, you know, I appreciated your comment about being careful about whether research is needed or implementation. I think what comes to the mind with a comment like this is that the funders that we are referring to might be quite diverse I don't know if people can comment on the diversity of funding. So if I think about federal agencies that have typically prioritize fundamental basic research or novel findings or new contributions in the research realm. Even they are starting to want to see more community engagement and yet they haven't released the calls from wanting also novel contributions to research. And so that's one set of funders that I think we want to see maybe a shift from but I wonder if maybe we can open this question up to, you know, are there some funding mechanisms we haven't discussed as much or what would it be like to nudge traditional funders in in more radical ways towards funding implementation work. So maybe open that up to the field and I think I've already editorialized enough. Thank you for the question. I think the funding question is, you know, the pervasive persistent thread through across every conversation today. I can't speak for academia but as someone who runs a very small nonprofit organization in one corner of the United States. Funding scenarios currently are getting better because we are working with the energy sectors and with health care and with housing and threading those that's fantastic. But the other reality that persists and I don't want to use this platform today just talk about all that is wrong because we're talking about what's going forward. But I was very struck to hear Ruth and Norton's, you know, outstanding work and the progressive work of the organization the impact they've had, but they're outlier. I don't have a $17 million budget I don't get $25 million grants. I don't get a chance to talk to legislatures regularly, you know we're working in the field we're trying to affect policy. The organization's budget might be $200,000 or $300,000 a year unless we get another big grant, but to even get that grant then takes about 30% of our time to write the reports and management I see 70% of my time is just managing the money we get. So, the other part that struck me when when she was speaking was a reminder that all we talk about collaboration collaboration until the cows come home to use a very old expression. But all the healthy homes and organizations that I work with. We might have a coalition we might have a meeting but then we're all competing. We're all on the phone the next day texting and calling for the same pot of money. And we will only selectively collaborate, because we need to fund someone we just hired right. So there's a lot of competition still at this, you know, sort of almost bottom feeding level of the smaller organizations that don't have adequate funding. So, quite that out. That's exactly why I'm so, you know, grateful for these amazing conversations, because again we're bridging worlds, it's, you know, in research and the funding spaces that we think of completely different world than exactly what you're describing. And, you know, what also struck me and something I think about a lot lately is in this space, you know weatherization preparing for climate change. The idea of resilience and not in the biological sense let's say or the community social sense but really in the, in a world where the climate, you know climate change is creating all these frequent massive weather and disaster events right. And I was thinking again this whole house approach was really impactful to me from Ruth Ann's talk right, but when we're designing these solutions and interventions and programs. Are we thinking of the plans B and C and D in the unlikely but very likely. Sorry, unfortunate but very likely event when you have multiple things happening together. Right, how are we moving away from let's think of one problem at a time to fix it. In indoor environments, there's multiple problems at the same time right. You know I hope just the funding landscape the research landscape the practice landscape is also thinking of these sort of multi pronged solutions to things and I don't know that I have enough experience to talk to this but I'd love to hear people's thoughts on it. I want to comment again here from my colleagues because the chat looks like his clothes but that they know the other theme that we've heard throughout the day that I don't know if any of us know quite how to tackle but the concept of regulating the indoor environment right is a very complex one, but that the agencies that currently regulate chemicals. And you may see this in least I do with EPA and FDA is that if they had more authority and more stringent standards to help develop and implement regulations. They're historically underfunded agencies, however, by Congress right, and that is one of the ways that if you're a conservative legislator that you can hamstring an agency is by cutting its budget and you know to give you an idea about $8 billion a year, that is about $40 billion a year, DHHS is $400 billion a year. And so when we ask EPA to do more, there is only so much they can do because they are truly chronically underfunded on purpose, so that they can't do enforcement necessarily, or can't do more promulgation of regulations. Any additional questions or thoughts from our audience online from our in room audience we welcome any of your sort of perspectives especially our speakers from today and yesterday we'd love to hear from you. What are some challenges that really stood out to you. After hearing all the talks these couple of days in your own work in your own space. I don't know if you can see anything on your end, I don't see the same view. Nothing that I haven't, I think already addressed. Good to Dr. neon, please. I guess this is more of a general question to the speakers and workshop planners. One thing that you would do differently tomorrow based on what you heard today. I think I'm going to go look up contractors first of all, but also really talk to practitioners in the field and try to understand. You know, and it's sorry to take over the conversation here but I think in my research world we talk a lot about community engagement and community based participatory research and again. Jill, Jill Johnston is reading my idol in the space and so our speakers. But I think I just love to learn more about the world of practice right I thought I knew but I my eyes are really opened in this workshop and then also figure out how in my own institution and sort of, you know, professional life, I can make space and I think we're carving out some more impactful maybe research work that I could be doing mission. I will say very quickly that I actually did my dissertation on asthma collisions and the concept of putting collisions as a powerful engine that can cross sectors and cross disciplines and can engage all strata, and the power of a coalition community members sitting at the table and side by side with regulators and researchers and practitioners. So, for me though the question is, I would like to see this particular conversation continue where we have a some kind of forum where the indoor air and academic research fields can continue to have this conversation. And I also see that we always approach gingerly the idea of regulation, and then we retreat, because we have our full time jobs and because we have families and lives, but I personally don't know how we can get the, to make a collective effort to advance that dialogue at the federal level where require all of this phenomenal knowledge but to be brought into one powerhouse and an advocacy type of setting. So I would invite anybody who wants to, I don't want to stay join me I'd like to say join us presumptively, but to create some something that comes out of this that says, you know, what is not being asked, you know, at the federal level right and how can we come together and create a message a policy platform for we should, you know, federal agencies should fund comprehensive analysis and assessment of what an indoor act would look like I would love to see the clean air indoor act amended or clean indoor air act in the United States at the long time coming. But who's going to do that right, we actually need a coherent group to move that conversation forward. So I think, for me, one of the things. Yeah, I have, like I teach people about healthy homes and I do it in kind of this whole home holistic way. And one thing I do talk about but I've learned a whole lot about in this workshop is about chemicals that are in various products and I do talk about and cleaning products. You know, there was people who had no idea that people were sticking mercury on their face to make their skin lighter. It's actually that kind of kind of horrifying. And I stand up in front of people and teach them about all this, all these different things. And I never mentioned anything about sticking mercury on your face because I didn't know it was a thing. So that's one thing I'm going to do different is start teaching people don't stick mercury on your face. I think also, I think one of the questions that I have is is also, you know, with all of these products when we talk about not necessarily personal care products that are at some level optional. I think there's a regulatory thing there in terms of the products not the indoor air but in terms of the products themselves to even before they get into the indoor air. But when you get into some other products like vinyl flooring and things like that. I think that I would, I would like to understand a little better is maybe a research area. You have to have something on your floor and carpets can be a really big problem. If you don't have carpets you're going to have a hard surface. There's going to be trade offs what are kind of the least worst options here. Trying to, you know, this gets into kind of the systematic approach, not the individual contaminant approach. But I think really trying to engage practitioners more with some of what's in products and in the work that I do on standards. Maybe you can't get laws passed right away, but it can be easier to get standards like ASHRAE and our air quality standards changed to address some of these issues. And that can be a foot in the door. So that would be that's I think one of the things I'm thinking of is how to start changing ASHRAE standards that I'm committee member for to address some of the issues about products that I've heard. These last couple of days. You believe Paul our committee member Dr Paul. Sorry, Bill Banff with would talk a lot about these actually perspectives as well and guidelines before we go to Dr Carter for your perspectives we have one more question or comment from the room please go ahead. Thank you very much. Again, thank you for the opportunity to be here and learn from you. I think for me, over the last couple of years, and specifically perhaps the last few months is, you know, when I enter spaces like this is to ask who was missing for what was missing from these conversations and very critical conversations about change right. And so, just kind of thinking through about this incredible institution that the National Academies is, is how can this institution very much like professional organizations like the American Chemical Society, the society for environmental toxicology and chemistry and others that are really leaders in the space of environmental toxicology and chemistry. What is their role, right, and where do these organizations actually fit. And how do we as members of those institutions challenge the status quo and say we have to do differently. We have to open up the spaces a little bit wider for many of the people that we spend the last two days talking about. Instead of talking with and how, you know, how do we more deliberately go about doing those things and so how do we bring in some of the people who had the very experiences instead of hearing from a slide. What they may or may not have said even the photographic, you know, those experiences and inviting them in. We talk about engaging young people. This is an excellent forum, I think, to bring some of those young people that that will work in and really hearing directly from them about their experiences. And I think bringing students of color to walk through spaces like the National Academies of Science can transform lives, right. And so, you know, overall for me is just continuing to question who or what is missing from these conversations and leveraging what we learn and taking it back. And then more practically with the question from the poster for the students online around how I can contribute how I can get into the spaces. You know, I work with neighborhood associations that have, you know, not very they're not organized right they're not 501 C threes which is where we're talking about funding. Some of them are fiscally sponsored organizations, and that's a convert that you know those are groups that we didn't even touch on here in terms of supporting the work that they're doing, literally on the front lines sometimes on fences of chemical plants right and they leave day in and day out of, you know, not only the outer space, but these materials and chemistry is entering their spaces. So there are a number of organizations, including the EPA, with with opportunities where student scientists, faculty members and others can volunteer time and work as a technical advisor on a specific question with a number of organizations, and I can share the links with with Linda, and maybe if that's a good way to go about it I'm not sure that it can be passed on to to those folks online who were asking. Thank you. Perhaps we can go to Dr Carter for your perspectives as well. Sure. So first I don't know who the most recent speaker was at the mic but I just want to say how much I appreciate the comments, especially around. Dr Carter will interrupt you for one second. Yeah, please. I'm sorry, my name is Laurel Roy. From which organization. I have my own consultant and environmental and human health firm called carrying out consulting and research and based in Atlanta. Thank you so much. Dr Carter please go ahead. Yeah, thank you very much for your comments. You know asking around who's missing I think that's always an important question to reflect on as we think about what's emerged as themes. And I think you already pointed out a number of ways in which engagement in this kind of forum is certainly appears to be easier for people that operate in research institutions or organizations that are large and work at the interface with communities and not necessarily community members themselves. In the last few years as we've been adapting to, you know, the disruptions of in person gatherings, your question or your comment brings to mind. If I may, my own reflections on what is the value of this kind of forum and what would it look like if we did it differently to maybe address some of those gaps. There shouldn't say of course but what comes to mind is sort of a more comical or silly group of troubadours like going to different places. Maybe Morgan State University that you know Ruth Ann mentioned, where instead of trying to bring everybody to a central location that has a certain look and feel. What would it look like if we were, you know, going to smaller venues doing things a little bit more inner personally or. Yeah what would it look like and that that's just something that came to mind as you were talking and I just really appreciate that your comments that, you know, spur that sort of thinking in me and, and, and how I conduct my work and maybe work with others in this space. I don't know if you want, if there are other questions in the room I don't want to take the floor I had a thought from Dr. Jones question about what would I do next but I don't know that it's relevant right now. Please we'd love to actually hear from you on what you would do next or differently let's say tomorrow based on the workshop and your perspectives. And if there are no more comments afterwards we might close up but please go ahead Dr Carter. I don't see any additional questions I know there is just from a more logistic standpoint a question around, whether the Q&A questions and responses will be recorded or disseminated in some way and so that maybe that's something that afterwards are an AS. And can address. I did appreciate the question about what to do next. And, and Rima I think you made the comment you. We can't do everything. I'm sure anyone no matter what perspective they're coming from may feel that way. There's, there are more things to do than what they might be capable of as an individual. So just couch my comment or my thought in response to the question about what I would do next is really, you know, narrowly scoped into the position that I hold which is at a research institution university at public university, and as a faculty member. Pretty narrow perspective, but from that perspective I think what I have maybe reinforced that front through this workshop is a desire just very simply to do more qualitative based research. I think I can probably come up with a long list of reasons why it feels really difficult in my job to align the incentives of my job with the things that I think are important. But there are aspects of my current position that I think afford flexibility and one of those is in how I choose to conduct research. I think something I've heard repeatedly here that, you know, I can say I know and maybe even have practiced a little bit but haven't really leaned in on is the regular engagement to learn what people are thinking about experiencing in their homes. You know, despite recognizing that that homes are a place of diverse needs being met. I've almost always gained entrance into a home by carrying an indoor air quality monitor of some kind. And so I come with the frame of I'm going to measure something that I think is important, and I haven't asked even before that entrance, whether they think that's important. So I think something I'm excited about in this, like, following this workshop and also at the stage of career I'm at is, you know, the opportunity to be a bit more expansive and how I conduct my research so that I can hopefully learn more about what would be worthwhile to pursue so that when there is research knowledge to transfer there are people that actually want the findings that that I've developed because they've been co developed with our, you know, with with with people who've already given a lot of thought to what it is that they would like to know about their homes and how to make them safe places for them and their families to live. Thank you so much, Dr Carter, Dr Middle said, please. In closing, I wanted to add something that I haven't been able to really share the last day and a half, which is the, the program that we do that I'm most proud of is called our air matters toolkits and our smoke matters toolkits and they and tribes and local communities have distributed almost 3000 to households. But the reason we created that is that takes away this hierarchical that we are helping and that we are knowing and that that the communities were helping and that we are knowing and it's saying, your toolkits, here's a lead and a rate on and a green cleaning and mold and moisture and a co detector and a hygrometer, and to engage and empower the members of those households to say, Oh, I can take the presence of a contaminant or a hazard. And again that's not trying to teach, we learn and activate best when we do our own search right and when we acquire the knowledge ourselves it's sort of this basic model. And so the idea behind our toolkits is that people will begin to ask questions, what is in my home, how is it related potentially to my health or my parents or my child. And so I always wanted, I guess I just keep thinking about how do we keep the individuals at the forefront of our thinking, and that as many other speakers more eloquently said, we learn from them, and we build and design programs we meet them with our our solutions, and then we learn from them, and then we meet and calculate something. So, just wanted to add that and just thanks so much to the academies to Dr. Habra. Dr. Carter Dr Stapleton for the planning committee, and all the people here who I just would continue to love and listen to for days, or could listen to how much Dr. Middelfed, we're grateful to you. I would like to give one final opportunity for anyone online to please chime in raise the hand ask a question if you'd like. Mary Patrick has shared that HUD has a healthy home program yes. Are they receiving this report so they can integrate it. Also there's a lot of research done on dangerous consumer products and how they affect health that can be used educational tool Thank you so much for sharing those links, Mary Patrick. And I'm pretty sure with our wonderful planning committee and our speakers. The report is being shared. Ricardo any final thoughts or should we close up the workshop. No, just my final thought is just a thank you very much to our speakers who I feel like we're, you know, very willing to showcase a diverse range of their work and I really appreciate the perspectives that were shared and the conversations that you know ensued. So thank you very much. It's a pleasure working with you all. Thank you so much. And with that I would like to also add my thanks my tremendous thanks to Dr. Middelfed for your wonderful, wonderful contributions to making this a huge success in my humble opinion. Dr Carter, Dr Heather Stapleton, who couldn't be with us today because of an urgent commitment. Thank you so much as our planning committee I'm very proud of what we've been able to accomplish today and really hope that we can continue kind of with this work and conversation. Together I know I learned a ton of new kind of knowledge and wisdom from our speakers. Thank you for being here with us in person and for everyone online for attending and speaking and engaging with us these days. I'd also remind folks to please be on the lookout and mark your calendars for our next dissemination workshop from this indoor chemistry report and study. It would be also at the National Academy's building on October 18, and it will discuss the state of funding for indoor chemistry research and as we sort of really got into the depth of the conversation here today it's such an important sort of grounding force right in terms of moving the field forward not just in the research but also in the implementation sphere. I would also like to thank Dr Linda Nyon for leading us in this mission of hosting and planning this dissemination workshop. Our wonderful study committee and partners and even getting the report out we all worked on it through COVID and I have to say I really appreciated that time and that connection and learning from all the experts.