A Second Opinion with Shirley Franklin | Healthcare Podcast | Bill Frist

A Second Opinion with Shirley Franklin

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In A Second Opinion, we engage with the leading minds in health care at the nexus of medicine, policy and innovation. In the current series of four episodes, we’re hearing from four leading women in health care. In today’s episode, I’m excited to be joined by Shirley Franklin, the former mayor of Atlanta and the executive chairman of the board of directors of Purpose Built Communities. Shirley Franklin, executive chairman of Purpose Built Communities, is working to break the cycle of intergenerational poverty, and thereby create a culture of health and wellbeing. She helps local leaders transform struggling neighborhoods and brings together the vital components necessary for holistic community revitalization. The 58th mayor of Atlanta, Shirley was the first woman to hold the post and the first African American woman elected mayor of a major southern city. Shirley helped Atlanta become one of the most progressive cities in the country. Stay tuned to hear how transforming a community can transform and individual’s health.

Bill Frist:           Let’s start right at the basics. The Purpose Built Community, I know what it is, you know what it is, a remarkable sort of amalgamation of concepts around the non-medical determinants of health and wellbeing. And that may not even be the main purpose, but what is a purpose-built community? And go ahead and jump in with the history as well.

Shirley F.:         Well, the good news is that we talk about this a lot. So Purpose Built Communities grew out of an initiative called the East Lake Foundation in Atlanta. And this was a community that had all of the indicators of a failed community, high crime rate, a low graduation rate, low employment rate, a community that was really considered one of the communities of last resort. If you had a choice, you wouldn’t live there. And Tom Cousins, who is a philanthropist, is a local business person and founder of Cousin’s Properties, a developer, the head of the Housing Authority, Renee Glover, and the tenent leader, the president of the Resident’s Association, after each of them wanted to see something different happen, came together and formed a relationship that they developed this model, which is a combination of three components.

Bill Frist:           Now wait a minute. How many years ago are we talking about?

Shirley F.:         Well they formed this model in the 1990s.

Bill Frist:           Good.

Shirley F.:         In the 1990s. Atlanta was getting ready for the Olympic games, at the same time there was a-

Bill Frist:           Now wait, did you do anything with the Olympics?

Shirley F.:         I did.

Bill Frist:           What’d you do? I know but our listeners and viewers need to know.

Shirley F.:         Well I had a great opportunity to work with Bill Bain and Andrew Young and some others, Bob Alder. I was responsible for local government relations, minority and female business, community outreach, and any-

Bill Frist:           Everybody says it wouldn’t have happened without you. That’s what they say.

Shirley F.:         Well they’re wrong.

Bill Frist:           I don’t know about that.

Shirley F.:         I’ll tell you one thing, it was a great time in my career. I had worked with Andrew Young for eight years.

Bill Frist:           Remarkable.

Shirley F.:         And I had a really great opportunity to work with Billy Bain and the entire team.

Bill Frist:           So this was before the Olympics or this was after the Olympics?

Shirley F.:         No, East Lake was before the Olympics.

Bill Frist:           Right, yeah.

Shirley F.:         It was around the early 1990s.

Bill Frist:           Right, good.

Shirley F.:         It so happens that Atlanta was getting ready for the Olympics. But it also was a time when Renee Glover and Tom Cousins and Eva Davis, they were feeling that we needed to do something different in public housing.

Bill Frist:           Yeah, good.

Shirley F.:         And I don’t know for sure but I think they came to it from different points of view. Somehow or another they got together. And Tom, through his philanthropy, said that he was committed to being a partner. And instead of just talk and ringing of hands and planning, with his very generous donations and his reach out into the corporate community, into the philanthropic community around Atlanta, and really around the country, they were able to put together a plan of about $150 million that include mixed income housing, housing for those who require some sort of federal subsidy.

Bill Frist:           Right.

Shirley F.:         He and the community and everyone knew that you had to have a great school. So an investment in school reform and school education.

Bill Frist:           Right.

Shirley F.:         And then something we had called support services at the time but have come to understand as community wellness. In other words, all of those non-medical determinants of health…

Bill Frist:           Right.

Shirley F.:         … that are important for people to thrive. But the key to this is not just the parts. The model, and I believe a lot of this had to do with Tom’s business acumen and experience, that you have to have a guiding organization, and that is a not-for-profit or a quarterback.

Bill Frist:           Right.

Shirley F.:         And the quarterback is a local nonprofit that is solely focused on the integration of all of the not just services but all the dreams and visions and plans are for a defined geographic area. So we call it place-based development.

Bill Frist:           Place-based.

Shirley F.:         So it’s community development that is place-based, fully integrated, holistic, and comprehensive, targeted primarily to the people who have little chance of moving up the socioeconomic ladder. Now, everyone is served but you design it in a way that people who have limited financial means or perhaps little education, and want more, are able to advance, and you remove as many barriers. So I call it barrier-free planning.

Bill Frist:           Yeah. You started with bringing three people together, Tom Cousins, who through philanthropy had some resources there, to an area that’s really underserved and need… So I understand the story but there are lots of places that have pieces of that. What was the gelling factor that really put it together? Or is it just putting all those few… Because it’s only four or five people really.

Shirley F.:         Well, each of them represented other people and had their own constituents.

Bill Frist:           And they represented diverse constituencies.

Shirley F.:         And diversity too. And Tom Cousins didn’t know Eva Davis, nor did he know Renee Glover.

Bill Frist:           Oh, is that right?

Shirley F.:         It’s not like a group of friends went out and had a beer and said, “Let’s do something together.” I mean they had to get to know each other. The first year or two, it was really about building trust. Eva tells this story. Miss Davis, who’s deceased, tells this story that she didn’t trust him, that he was rich and he was white and he seemed like everybody else who was making promises who never delivered. And she came to be one of the big supporters of the project. But the key for us is a clearly defined mission, clearly defined components, and a group of in a not-for-profit, a quarterback that is committed to seeing this through for five, 10, 15, 20 years so that you’re not rotating leadership. The leadership is really coming from the not-for-profit. The success, however, is the result of that quarterback being able to bring other partners to the table.

Bill Frist:           Right.

Shirley F.:         Because even with his resources, Tom Cousins wasn’t able to provide everything that was needed, either expertise or money. Even no matter how good the school is, children have to go home. They have summers off and holidays off, so something has to happen in the community when the school is not functioning and open. And the community wellness, really we’ve learned a lot in the last 20 years. We started out not thinking about health at all, and now realize that much of what we do impacts the health of individuals and families. And we’re been excited by all that we’ve learned from the medical profession and also from the social scientists.

Bill Frist:           That health and wellbeing sector, it really reminds of why I wanted this discussion with you. In the past, on this podcast, we’ve talked a lot about the non-medical determinants of health and wellbeing. And health and wellbeing is so fundamental as a human right, as sort of defined by people generally. And health and wellbeing, we have learned, is not people like me, the heart surgeons, and it’s not the hospitals and is not the health insurance and is not the health care plan. All that’s very important and a lot of people listening to me right now are saying, “No, that’s what’s important.”

Bill Frist:           But we know today that it is housing, it is the food that we eat, that we nourish our bodies with, it is the access to sidewalks and community and outdoors, it is access to the internet, some basic learning but also when it comes to telemedicine and telehealth. And so much of what we talk about, even on this podcast, takes one of those silos, food… I have a food company that invests in food to the Medicaid population after hospitalization, which is all very good.

Bill Frist:           And what I want to continue to explore with you and the reason why this conversation is so important, what you and others have lead and built with this story is a purpose built, meaning all of it is put together in the word you used, it’s holistic. It’s pulling all these non-medical determinants of health and wellbeing together. And once they’re together, it allows people to align, to debate. And your description of bringing people together who didn’t know each other at all from diverse background for the first time. Because if everybody says we’re going to build a community, it means you’re going to talk about the food and the sidewalks and the access to the internet. And I think that’s where the great advances are going to be made coming forward.

Bill Frist:           And I wanted to put all that out there because I know a lot of our listeners are saying, “Now how does all this fit with health and wellbeing and lifting people up?” And that’s sort of the strategy. And I had the opportunity with you yesterday to tour the community here at East Lake, and I see how real that is. And so I leave Atlanta, where we’re sitting now, not a convert but even a greater believer in this pulling it together. So continue with the story. Right now, when we go to East Lake, what do we see?

Shirley F.:         Well, when you started at East Lake, what you saw was a crime rate 18 times the national average. What you saw was low home ownership, vacancies even in public housing. You saw parents who were having a hard time taking care of their children and couldn’t even leave their children, they didn’t feel it was safe for their children to play outside, a school where the vast majority of children were underperforming their abilities, and certainly not meeting any of the state or federal, nation standards on education, and people who had a sense of hopelessness.

Shirley F.:         Now, they will say that it still was their community, so we don’t want to underplay the fact that there was a sense of community. But they had limited resources, few options. It would be hard to tell your child that you could be anything you wanted to be and do anything you wanted to do as an adult, based on your dreams and your talents, and really mean it. Because there was very little opportunity for young people or even adults to realize their dreams.

Shirley F.:         So now, you go and you see one of the top-performing schools in the city and in the state. A school that was underperforming is now always ranked in the top three, four, or five schools. The school is completely full. There’s a waiting list for children to come. It’s a public school. It’s a public charter but it is a public school. It serves children in that community. You see children who are participating in a full array of activities, anywhere from golf to robotics to engineering.

Bill Frist:           I love the engineering. And when you see the third graders and they’re building and designing and implementing these engineering projects, it sort of blew my mind. And I think seeing that starting in the third and fourth grade and continuing the movement to the upper school, seeing the seniors in the high school looking at a field like engineering and then siting their experience when they were in the third grade.

Shirley F.:         Oh yes.

Bill Frist:           It opened the world to them and inspired them. It was really not revolutionary but it was hugely remarkable to somebody such as myself.

Shirley F.:         Well, I’ll tell you, they start in Kindergarten.

Bill Frist:           Yeah, that’s right.

Shirley F.:         Kindergarten, first and second grade design play equipment that they actually build themselves for the playground. And so they begin to teach problem solving and the principles of engineering. And the STEAM coordinator, because this is a STEAM school, STEM plus art.

Bill Frist:           Right.

Shirley F.:         The STEAM coordinator says that the way you start this is really as young as you can. So they design their own musical instrument and they go through the entire process of start on a piece of cardboard or a piece of paper and then you move to the equipment that they have in the building.

Bill Frist:           And I saw them designing a little movie. Again, these are third and fourth graders.

Shirley F.:         Oh, absolutely.

Bill Frist:           But developing the idea, coming back and refining the idea, and then actually shooting the movie and then actually distributing it. I mean, to me, that was sort of an experience. So we start with education, which is remarkable.

Shirley F.:         And then housing.

Bill Frist:           Yeah. I have to say, because that was Drew. Because it’s Drew charter school, but Dr. Drew was a surgeon, right?

Shirley F.:         Yes.

Bill Frist:           In my field of surgery, he was a great surgeon who in the whole blood banking field and the blood world is unbelievable.

Shirley F.:         Charles Drew was the name of the original school. And we kept the name…

Bill Frist:           Yeah, Charles Drew.

Shirley F.:         … and it’s a great tribute.

Bill Frist:           All right, so education, fundamental.

Shirley F.:         So education is part of it, but it’s a neighborhood school. In other words, you can walk from your neighborhood. You can walk from your housing to the school. you can walk to the grocery store. There had not been a building permit in that neighborhood for almost 30 years before this project, which means there was no real investment in the community. Some $400 million has been invested privately, and not in the project, outside the project, in restaurants, a grocery store, gas stations, other small businesses.

Bill Frist:           Right, yeah.

Shirley F.:         So now people have jobs in the neighborhood as well.

Bill Frist:           On the school again, for our listeners. And we know this, but the correlation between education and health, education and obesity, education and diabetes and in heart disease is really important for people to understand, that education, basic education, K-12, but even earlier than that, is fundamental to having health and wellbeing. And that’s for heart disease, diabetes, obesity, likelihood of smoking, you go down the line, it’s fundamental. Okay, so what’s…

Shirley F.:         Well, and I want to stop on education. Because the school starts at six weeks.

Bill Frist:           Yeah, cradle, they’re cradling.

Shirley F.:         Cradle to college and career.

Bill Frist:           That’s right, I’ve heard that again and again and again.

Shirley F.:         So the school started K-5. Then we expanded K-8. And then the educators said to us, “You need to go back earlier than K,” and we went to fourth grade and then third grade. And then, eventually, we have almost 300 children who are enrolled at six weeks to three years old. And that program is a literacy-based program teaching all of the skills related to literacy. So when those children leave at three years old, they are actually knocking the socks off of anyone else who’s in the school in terms of their academic achievement. But children learning how to communicate, how to use language, the value of using language. I don’t know, I saw a little Kindergarten… I know this is off topic. One of the Kindergarten classes, and there was a sign on the door. And the sign, when I first looked at it, it looked like scribbles. And then one of the teachers came and said, “No, those children are writing their names.” So they had written their names as they knew how to write them,…

Bill Frist:           Isn’t that amazing?

Shirley F.:         … all on top of each of other.

Bill Frist:           Isn’t that amazing?

Shirley F.:         But encouraging them. And then other sign was it’s project-based learning. So project-based learning means you take a problem and attempt to solve the problem. And the one for the entire school, pre-K all the way to 12th grade, is related to climate change this month. And so everyone, regardless of the age of the child, is grappling with the issues of climate change.

Bill Frist:           Fantastic [crosstalk 00:19:57].

Shirley F.:         But the school is part of the heartbeat of the community because parents can gather there, the community can gather. And it’s designed to be a place the children want to go and that is child-focused. We’ve talked about some of the non-medical determinants of health, but one that many of the children who are hungry, who are living in circumstances where they are exposed to violence or stress, we know from the science now that that impacts their brain development, that impacts their personal development, and ultimately impacts their health long term.

Shirley Franklin

Bill Frist:           For the rest of his life, for the rest of his life, yeah, yeah.

Shirley F.:         For the rest of your life. So you have to have some sort of intervention. And the school has several areas where it intervenes. From the very beginning, we had a nurse on staff. From the very beginning, we had psychologists in the school. From the very beginning, we had family counseling. And I mean back in those days, at the early start of the school, I was the founding chair of the board. So it was an eye-opener to me that we needed to do more than just have good classroom teachers or more than just good principals and the right materials for children, and supplies. I mean we have to treat the whole person.

Bill Frist:           And then a lot of people listening will say, “Well that’s good, but that’s a lot of resources coming in that my local school doesn’t have, can’t get.” And the thing that we explored, as I was going around yesterday, was that’s true in a lot of places but what we’re doing is developing the curriculum, demonstrating that it works, and then sharing that broadly with others, other public schools, non-charter as well as charted traditional public schools. And then what we do with the resources that we have, have been able to demonstrate the importance of early childhood development, that the project learning process and deliberative opening and reasoning is a way that young children are equipped very early on to address their future, but is shared throughout the local community as well, which I was impressed with.

Shirley F.:         Well, it’s designed to be a laboratory [crosstalk 00:22:31].

Bill Frist:           Exactly, exactly.

Shirley F.:         And sometimes that’s the best way, to try something and to test it. And you can do it perhaps in a smaller setting. I think there are 1,800 students in the school now.

Bill Frist:           Right.

Shirley F.:         We started 300, so it’s really grown.

Bill Frist:           Yeah, you’ve seen it all. You were there.

Shirley F.:         But the key is housing too.

Bill Frist:           Yeah, I was going to say move to that. Let’s shift.

Shirley F.:         It’s important to recognize that the housing was built in a way that is mixed income. So there’s public subsidy, traditional public housing.

Bill Frist:           Right.

Shirley F.:         And it’s also market rate.

Bill Frist:           Right.

Shirley F.:         And in some cases we might even use tax credits. So that’s another way of funding it. Because you want to fund tiered housing so that when people are able to move and to pay more and to be more engaged in the cost, they don’t have to move out of the neighborhood. So there is housing. There are over 500 units. All of the families have first right of refusal or first opportunity to come to the school. It’s on a bus line, it’s across the street from a brand new… Well it’s not new anymore, a 15 year old grocery store. There’s a Y that has a sliding scale for membership. The Y is committed, the YMCA in this case, is committed to raising the money for scholarships so people are not turned away. So if you walk through the Y on an average day, you’ll see people, senior citizens who are doing water aquatics, and you’ll see children who are swimming and learning to swim from the school, and you’ll also see people from the community. When we started, it was a two or three room Y with maybe 15 people at 10:00 on any given day. Now it’s full of people.

Bill Frist:           Oh, yesterday when we came in, I was meeting somebody over there. And they came, said, “We’re never going to find you.” I said, “What do you mean?” And they said, “There are people exercising and the diversity coming through here. There are people studying here. The people are having social interaction in terms of meetings here.” And again, that’s what you want.

Shirley F.:         That’s exactly what you want.

Bill Frist:           You want this amalgam of a meeting place. It’s safe for people. It focuses on health and wellbeing and exercise of the mind and of the spirit, all of which comes together. Quite a remarkable place they were saying yesterday.

Shirley F.:         And the Y serves as the physical education department for the school.

Bill Frist:           Yeah.

Shirley F.:         So you have the young people, the children, actually coming over into the Y during the course of the day who are getting their physical education there, whether it’s swimming or whether it’s some other kind of sport in the gymnasium.

Bill Frist:           And again, I think the message is this rich, integration of, as you said, the YMCA with the school and the flow of the housing and the neighborhood that really are what it takes in many ways to produce well-adjusted, in the sense of healthy and fulfilled and the wellbeing that we know that people want to achieve, can achieve.

Shirley F.:         But Senator [inaudible] there are people who are listening who want to just live by themselves, off in a quiet place, in a wooded lot, isolated. This is not the place for them.

Bill Frist:           I saw that yesterday. [inaudible 00:26:07].

Shirley F.:         I mean this is the place where people want to experience community.

Bill Frist:           Again, so what are the results of all this? I know it’s a process that will continue to evolve overall but are you pleased with the results and are there measurable results from where we started to where we are today?

Shirley F.:         Well, there are some measurable results. But we are really looking forward to a relationship with Robert Wood Johnson Foundation, who’s going to help us identify the metrics, the additional metrics we should be measuring. So the first graduating class, 100% of the students graduated from high school. We have low obesity in the school. We have low absenteeism. We have low turnover of teachers. These are all indicators that this is a healthy place to be.

Bill Frist:           Right.

Shirley F.:         We have high levels of student engagement. We have low turnover in the housing, regardless of whether it’s market rate or publicly subsidized. We have a grocery store that’s one of the top performers a block and a half from the housing and a block and a half from the school. So I mean those are indicators. This is a Publix grocery store. They took a risk in a neighborhood where there had been no investment in grocery store and they’ve come and it’s been a thriving store with a pharmacy, with a bank. Many of the people originally were unbanked. So we now have two banks in the community. The crime rate is 50% of the city average, so it’s low. And this was a neighborhood that had all of the indicators on the other side. Now that’s 20 years in. That’s 20 years in so probably the most important lesson is there is no silver bullet. There is a plan and there is a model. There’s a lot of persistence and hard work to keep it moving in the right direction.

Bill Frist:           That’s exactly why, and it takes people like you who have been there really at the outset to lead and to stay with it and get involved and the community commitment. But that period of 20 years, you’ve had a lot of learnings. We make it sound like everything’s easy, and it’s not easy. But tell me a little bit about the Purpose Built Foundation or Community, whatever the word is, where you actually go out and consult with other communities to share what you’re learnings are.

Shirley F.:         So about 10 years in, people came, people like us came. They’d either hear Tom Cousins talk about it or they’d hear someone else talk about what was going on at East Lake, and they started coming. Some federal officials came. And they’d look at this integration, this model, this framework. And many people went back to their neighborhoods and said, or their communities and said, “We want to do that.” And Tom and his family became frustrated because, persistent man that he is, he would call, follow up on how’s it going, and he found that people were hitting the wall or they had stumbling blocks and it seemed too hard. So he and several other investors decided to spin off an organization. So we started with the East Lake Foundation and the charter school, and then he spun off an organization that is a consulting group that is pro bono, fully funded by philanthropy, to assist other people in, for want of a better word, replicate or reproduce or modify, use this model. So now we have 27 projects at various stages of development.

Bill Frist:           And they’re all not exactly like East Lake.

Shirley F.:         They’re all exactly like East Lake in this sense, they all have mixed income housing, they all have cradle to college and career, they all have community wellness. And some actually have medical clinics involved or are associated with a medical school.

Bill Frist:           Right. Education.

Shirley F.:         And they all have the cradle to college and they have a quarterback.

Bill Frist:           Yeah. And quarterback, say it one more time. I know you defined it once.

Shirley F.:         The quarterback is the local not-for-profit that is responsible for executing the plan that is mixed income, cradle to college, community wellness, fully integrated for those who are the lowest income to benefit everyone in the community. In other words, you’re building the community in a way that everyone wants to live there, but with a focus on the people who are lowest income and have the biggest socioeconomic hurdles to overcome. And so that’s the model.

Bill Frist:           Yeah. You know, you and I first met in 2013, six, seven or eight years ago. I think it was 2013, Robert Wood Johnson Foundation commission. And well, we came out of that and defined what we already knew, and that was that there are barriers out there that can be broken down in a community and that you really do have to look, you have to start at where you work and where you live and where you play and where you pray, and build that community and that alignment. This seems to be the perfect embodiment of what we studied back then. Is that right?

Shirley F.:         It’s closely aligned. And Robert Wood Johnson came to Purpose Built Communities, our organization, and said, “We think you’re having an impact on health.” And we said, “What? Really?” We didn’t know. We weren’t looking at it from that standpoint. We were looking at place-based development. And the more we learned in 2011 and ’12, the more we realized that we were a part of this movement to close the health equity gaps, to close the gaps, to increase equity, and to make America healthier. And our focus is on the lowest-income communities. And that’s not the only place America needs to focus, as you know.

Bill Frist:           But if you look at counties, county by county across America, and you look at the relative rankings… You can go to the Robert Wood Johnson Foundation website and do that. And we’ve done it in Nashville. And our 700,000 people in Nashville, our population health, our 45 measures from obesity to child mortality to smoking to access to sidewalks, to the whole 45 of them, we don’t do as well as many of our sister or brother cities, comparable cities. Yet, we’re a big health care ecosystem. Health care, not health but health care, ecosystem.

Bill Frist:           And then we just did a big survey, a Nashville health survey, a group called Nashville Health, which is this 501(c)(3) quarterback-type group that you talked about. And we found that it’s the disparities themselves and it’s these pockets, and if you do address these pockets well your overall average will skyrocket. And we’ve learned that you need to really focus. If you really want to improve the health of everybody, that if you focus on the communities like that, if you put a purpose-built community in that area, that all of a sudden the overall health and wellbeing, not just the average but the overall health and wellbeing will come up.

Shirley F.:         And the individuals do so much better. And that’s the overall goal.

Bill Frist:           That’s what it comes down to, that’s right.

Shirley F.:         Yeah, that’s what it comes down to.

Bill Frist:           That’s the why, yeah.

Shirley F.:         And East Lake was such a community. Remember, this was the most… This was a war t-, they called it Little Vietnam in the 1960s, 1970s, it was Little Vietnam.

Bill Frist:           And that’s the inspiration, the fact that it can be done, it has been done. And that’s why I was with you yesterday and that’s why we’re talking today is that it doesn’t have to be the exact same model. Because the YMCA, not everybody has to have the YMCA.

Shirley F.:         Right.

Bill Frist:           You have to have something that fulfills that. But the fact that it can be done and it has been done is really inspiring. It’s inspiring. First of all, congratulations. But to our listeners and people around the country, it’s really inspiring because if you can do it here you should be able to do it anywhere if you really put your mind to it.

Shirley F.:         Well that’s our theory. So we have 27. We just added-

Bill Frist:           You mean 27 different communities, Purpose Built.

Shirley F.:         27 different communities.

Bill Frist:           Yeah, that you’re somewhere…

Shirley F.:         Three in Atlanta, and 24 spread across the country. And we’re working with another 50 groups in different parts of the country who want to get involved, everywhere from Chicago to West Palm Beach and going west. I mean we’re in Omaha. Spartanburg is a small city in South Carolina. What it takes is local leaders who are willing to kind of disrupt the status quo. The status quo is operating in silos. There’s a comfort in doing your thing. You do your thing well and you have good results with that, and then you don’t worry about what anyone else is doing. We would argue, and do argue, that that’s wonderful but if you can combine those efforts it’s more than one and one equals two.

Bill Frist:           Yeah, the synergy. Yeah.

Shirley F.:         You actually get three, four, or five.

Bill Frist:           It’s exponential almost, yeah.

Shirley F.:         It really is exponential.

Bill Frist:           We saw it yesterday. And for those who are watching, this podcast is both video and otherwise, they’ve seen some of the footage from yesterday as we’ve talked here today. And it is inspiring. And on our website we’ll put how to contact… We won’t put your email and address on there but we will for the consulting aspect of Purpose Built. Let me close. And again, thank you so much

Shirley F.:         May I say one other thing?

Bill Frist:           Yeah.

Shirley F.:         We think, and we did a back of the envelope analysis of neighborhoods. Not communities now, neighborhoods.

Bill Frist:           Right.

Shirley F.:         Neighborhoods are usually defined by city planners.

Bill Frist:           Right.

Shirley F.:         It is a formal way to identify the geographic boundaries. There are a little over 800 neighborhoods where, if you did this kind of intervention, you could change the social and health equity issues in a generation.

Bill Frist:           Wow. That is fantastic. Can I site that somewhere? Is there a source?

Shirley F.:         Sure.

Bill Frist:           I mean I’ll put it on there. I’ll put it on our website.

Shirley F.:         Yeah, I’ll find that for you.

Bill Frist:           You know, again, these are big ideas. They’re big dreams. And your whole life has been one of taking the big idea and the big dream, not just having it but making it happen. And obviously we respect that and we admire that so much. And in closing, let me run through a couple of those. You can just comment on it in a sentence. What did you learn from doing the Olympics here in Atlanta? Because you were… I mean everybody points to you, when you walk around here, and say, “She’s the one that made it happen.” But just a sentence, what did you learn over that period of time?

Shirley F.:         I learned that Atlantans and Georgians love to host the world. They’ve done it in 1895 for the Cotton States Exposition and they came back for the Olympics. And they were just thrilled that they could share their culture and their arts and their dreams with people who visited us.

Bill Frist:           I love it. Okay, what about being mayor? You were the first African American woman mayor of this city. Again, I don’t even know why I specify that, but obviously at the time it was national news and all. But the one sentence of sort of what did you learn by being mayor.

Shirley F.:         I actually improved my sense of humor when I was mayor.

Bill Frist:           You had to.

Shirley F.:         I had to.

Bill Frist:           To survive.

Shirley F.:         I was a pretty serious person before that. What I learned as mayor is that people from all walks of life really want to help their community do better. I mean people volunteered to help each other in very particular ways right after hurricane Katrina hit the Gulf Coast. Atlanta just opened up its heart.

Bill Frist:           Right.

Shirley F.:         And their pocketbooks and their homes. We’ve seen that with snowstorms. We’d rather not do it with snowstorms. I really just learned more about the heart of the people. I personally learned to not take myself so seriously.

Bill Frist:           Yeah. National Museum of Civil Rights. It’s the National Museum of Civil Rights and…

Shirley F.:         Civil and Human Rights.

Bill Frist:           Civil and Human Rights. You’ve been such an important part of that. And again, I had the opportunity to tour that. It’s about five years old and a remarkable place and an engaging place, an emotional place itself. But what have you learned there?

Shirley F.:         Well, the National Center for Civil and Human Rights was the dream of Andrew Young and Evelyn Lowery. And I adopted their dream. And I learned that the hard work pays off. It was hard to do. It was hard to do. There were many people who are generous with their time and resources in Atlanta, but people were afraid to tell the Civil Rights story. And I believe that we have done it in a way that is inspiring,…

Bill Frist:           Unbelievable, yeah.

Shirley F.:         … as opposed to depressing.

Bill Frist:           Yeah. It’s unbelievable. I left inspired. And when I was talking to a group afterwards and they said, “What hit you the most?” Obviously the Nashville component of it.

Shirley F.:         Sure.

Bill Frist:           There’s so many friends of the Civil Rights leaders that early on in the civil disobedience and the list of behaviors… But I left really uplifted that the equity issues, the struggles and all, but this sort of sense of justice and there’s a higher calling for all of us. And again, I congratulate you, but the whole city for pulling that together. It’s five years old. It’s over near one of the Coca-Cola museums, over there.

Shirley F.:         Yes, it is.

Bill Frist:           And I want to encourage people to go there.

Shirley F.:         Well, the National Center is designed to be a place where people can engage around the current human rights issues and use the Civil Rights Movement as the platform for that conversation.

Bill Frist:           And that came on the final floor that you end,…

Shirley F.:         Yes.

Bill Frist:           … that it’s about that era, but that era has its parallels in every generation.

Shirley F.:         Absolutely.

Bill Frist:           And so many other sectors of that came up [crosstalk 00:41:53].

Shirley F.:         One of my favorite… This is off your question a little bit, but one of my favorite times at the center was there were several business people who had been really instrumental in helping this. And they really took a leap of faith. This was not something they normally would’ve done.

Bill Frist:           Right.

Shirley F.:         And we had developed a good working relationship while I was mayor. And just before it opened, I knew that it was going to get national attention and press.

Bill Frist:           Right, yeah.

Shirley F.:         And I didn’t want them to be caught flatfooted, not seeing it.

Bill Frist:           Right, right, right, right.

Shirley F.:         So I invited several, I would take them through it myself so they’d see it.

Bill Frist:           Right.

Shirley F.:         And I stood in front of the bus, the Freedom Riders bus, with all the photographs of over hundreds of people who participated, students. And this CEO of a Fortune 500 company, it doesn’t matter who he is right now, and he grew up in the South. I grew up in Philadelphia. So he grew up in the South. This was his era. And he was a young man then. And he looked at me and he said, “Shirley, it’s just the way it was. I never really understood it could change. I’m so glad those people proved me wrong.”

Bill Frist:           That is so good.

Shirley F.:         But when you touch people personally like that, that’s the whole idea.

Bill Frist:           It gets at this core of humanity.

Shirley F.:         It gets into the core.

Bill Frist:           Then to all of us, to all of us.

Shirley F.:         Yeah, I mean here’s a guy who does great things in his business life, in his philanthropic life. But he really had to look at himself.

Bill Frist:           Yeah, yeah.

Shirley F.:         And you know that’s going to impact him going forward.

Bill Frist:           Yeah, it does. Once you do it, once you’ve felt it. And that’s what the museum does.

Shirley F.:         So I’m sorry I went over a sentence. Pardon.

Bill Frist:           No. No, no, no, that’s exactly… Thank you very much.

Shirley F.:         Thank you.

Bill Frist:           I really appreciate it. And it’s been a great eye-opener to me to see all that you have done for this city and others have done for this city as well when it comes to health, the culture of health and wellbeing. But thank you very, very much. Appreciate it.

Shirley F.:         Thank you very much.

Bill Frist:           Thank you.

Shirley F.:         My pleasure.

Bill Frist:           You bet. Thank you.

Bill Frist:           This episode of A Second Opinion was produced by Todd Schlosser, the Modus Creative Group and Snapshot Interactive. You can subscribe to A Second Opinion on Apple Podcast or wherever you’re listening right now. And be sure to rate and review A Second Opinion so we can continue to bring you great content. You can get more information about the show and our guest and sponsors at asecondopinionpodcast.com. That’s one word, asecondopinionpodcast.com.

Bill Frist:           Be sure to join us for our next episode with my good friend and colleague, Dr. Peggy Hamburg, a physician, former commissioner of the New York City Department of Health and the 21st commissioner of the FDA. She’s currently serving as the chair of the board of the American Association for the Advancement of Science. A Second Opinion broadcast from Nashville, Tennessee, the nation’s Silicon Valley of health services where we engage at the intersection of policy, medicine and innovation.