[00:00:00] Adam Walker: From Susan G. Komen, this is Real Pink, a podcast exploring real stories, struggles, and triumphs related to breast cancer. We’re taking the conversation from the doctor’s office to your living room.
[00:00:17] Welcome to the Komen Health Equity Revolution Series on Real Pink, where patients, advocates, researchers, and community partners come together to talk honestly about what’s standing in the way of breast health equity and what we’re doing to change it. I’m your host, Adam Walker. Let’s get into it’s Women’s Health Month, which means a lot of awareness messaging and a lot of conversation about why women’s health matters.
[00:00:41] But today, we’re going a level deeper because awareness doesn’t save lives, action does, infrastructure does, investment does. And honest conversations about why the system isn’t working equally for everyone, those matter too. My guest today is Jenica Patterson, a neuroscientist turned health systems architect who is doing the hard work of figuring out why women’s health is so chronically under-invested and what it will take to fix it.
[00:01:09] She leads the Women’s Health Network at the Milken Institute, one of the most powerful cross-sector coalitions in this space. Before that, she built a $113 million federal grant program at ARPA-H, the Advanced Research Project Agency for Health, specifically designed to fast-track innovation for women’s health.
[00:01:31] Komen is focused on breast health access, and the sobering reality is that where you live and what you look like still determine whether you get a timely mammogram, an accurate diagnosis, or the best possible care. Jenica has the research, the relationships, and the conviction to tell us exactly why that is and what’s possible, and I’m glad she’s here.
[00:01:54] Jenica, welcome to the show.
[00:01:56] Jenica Patterson: Yeah, thanks. I’m so excited to be here.
[00:01:58] Adam Walker: I love the work that you’re doing. It’s so important and I’ll, I would, I assume you have a fascinating perspective as a neuroscientist by training that ended up leading one of the most prominent women’s health policy systems and initiatives in the country.
[00:02:13] So how did that happen? Like, like walk us through- … like, how, like the path from neuroscientist to, to, to that. Yeah. And what does it tell us about how this field works?
[00:02:24] Jenica Patterson: Yeah, absolutely. So yeah kind of an interesting career. It’s not the normal path that you take as a PhD scientist, but we also, we always talked about it as alternative careers back in the day.
[00:02:37] But I think it’s changing now. I think people really want to make action, as you mentioned. So I think that’s kind of where it led me in my life. But in the beginning as a neuroscientist, I really focused on understanding the biology at the bench, and that was early at my PhD as well as my postdoc at NIH.
[00:02:57] I was deep really in the science, but then I had the opportunity to kind of move those discoveries to the bench side, and that got really exciting. Like, “Oh my gosh, this science actually matters and can make a change in a human.” And then I moved over to DARPA and later ARPA-H. These are the ARPAs of the world.
[00:03:15] If you don’t know them, they really help build those integrated teams to really move a field of 20 to 30 years in the future. And I had the opportunity there to work across multidisciplinary teams, so engineers, clinicians other program managers at the ARPAs, investors. And you really could see how you could move an innovation from an idea to implementation to reach a patient.
[00:03:41] And that really started kind of, kind of my ideas of seeing the pipeline of what those barriers are from getting an innovation from the bench to the bedside to the market. And what became clear to me, even as a scientist at the bench, is that there are major barriers that are rarely just scientific. Clinical validation, regulatory pathways with the FDA, reimbursement pathways.
[00:04:08] Is this a viable market opportunity? And in women’s health, I’ve noticed throughout my career that these barriers show up even earlier. I could go on and on about all of the cell models, all of the pathways that you learn as a scientist are based on models from either male cells, male rodents.
[00:04:28] So it’s kind of s- built systemically into the system. And unfortunately, they didn’t include animals, different sexes in animals until 2016 from NIH, so ex– right? And women in clinical trials in 1993. So you can see kind of where these big barriers show up. And I think just going back, I think my path has really been about zooming out, kind of starting from the understanding the basic biology to understanding systems as a whole and what needs to get done to move those innovations to the hands of patients.
[00:05:06] And I think for women’s health isn’t a single discipline problem. It’s really a systems problem. So I think we really require coordination across science, policy, markets, and that’s exactly what we’re doing here at the Milken Institute.
[00:05:22] Adam Walker: I love that. So, so I guess what I’m hearing you say is, like, it wasn’t enough to study and discover the problem.
[00:05:27] You had– You wanted to be a part of the solution as well. Is that a summary of that? That’s right. I love it. I love it. Solutions-focused. We need some solutions. So I really appreciate that. Now when you describe the state of women’s health to someone that, that’s outside of the ecosystem how do you frame it?
[00:05:45] What do you want them to understand about it?
[00:05:48] Jenica Patterson: Yeah. I think there’s this big pivotable moment right now in women’s health. I would say we’re at a major inflection point. I felt the momentum happen two year, two to three years ago when we started to build this sprint for women’s health. There’s these extraordinary innovations that are emerging, new diagnostics to treat endometriosis that never exist or therapy, non-invasive therapies.
[00:06:13] New care models as well. You think like the Midi Healths of the world really supporting women where they are in their life. But those innovations are there, but the systems generally have not caught up to support it.
[00:06:28] And I, yeah I think importantly, the gaps really aren’t just at the market level.
[00:06:33] I think, as I mentioned before in my career, they start at the bench, right?
[00:06:37] Adam Walker: Yeah.
[00:06:38] Jenica Patterson: What gets studied? What conditions get prioritized? What animal models are you using?
[00:06:43] Adam Walker: Yeah. Yeah.
[00:06:44] Jenica Patterson: Make sure you’re not using all male mice. I’ll just throw it out there. And it continues through clinical trials.
[00:06:50] You think of conditions that differently affect women, like cardiovascular disease. The presentation is different, but the clinical trials aren’t reflecting that. So I think there’s a lot of areas where we have to look at women’s health kind of throughout that entire pipeline of innovation from the bench to the bedside to the market, and really what are those gaps that we want to fill.
[00:07:13] But I think at the end of the day- I want people to understand from a women’s health perspective, there’s a massive opportunity here. Not only– You know, we’re fifty-one percent of the population. It’s been stated it’s a trillion-dollar market, GDP opportunity, and I think if we align these systems and the market to support women’s health across the entire pipeline, we don’t just improve outcomes for women, we really build this more effective health system overall.
[00:07:42] Adam Walker: Yes. I love that. I love that. So and it-it’s interesting, you said something and it sorta sparked in me, like, this understanding that I’ve never thought of, which is that, like, technology and innovation and science move very quickly, and, like, where we’ve come in breast cancer over the last twenty-five years is astounding.
[00:08:01] But the systems don’t move that quickly at all, right? And so and so we, we need to help them catch up, essentially. Is that kind of part of what you’re saying?
[00:08:09] Jenica Patterson: Yeah, absolutely. I mean, it– there’s been massive innovation. Well, I mean, the mammography machine, which we’ll talk about in a little bit, has been a massive change for screening, but then there’s ultrasound.
[00:08:20] There’s other opportunities that innovations have been created, like a I know there’s a company that’s created a portable ultrasound for women to do s- breast screening, but there hasn’t been that system set up to scale it, to get it to patients for them to use it. Exactly, yeah.
[00:08:38] Adam Walker: Yeah I really app- I’ve never really realized that distinction.
[00:08:40] That’s really helpful, though. Thank you. So- Yeah … so back to, you mentioned mammographies. Let’s dig in there. Yeah. So the Milken Institute recently released research on mammography access across the US. What were the most alarming findings- Yeah … for, to you and then was there anything that surprised you?
[00:08:55] Jenica Patterson: Yeah, absolutely. Well, if you haven’t read it, you should read it. So everyone that’s listening, please download the report. It’s pretty quite interesting.
[00:09:05] Adam Walker: Okay.
[00:09:06] Jenica Patterson: Well, so I think one of the s- striking findings is really how uneven the access is. It’s how much gets hidden also when we define equity too narrowly.
[00:09:18] And there I think it’s not just the access it’s really making the definition broader so we can really make sure that we’re r- meeting patients where they are.
[00:09:28] Just to back up we took a very data-driven approach here. We combined country-level cancer data, demographic data, and we actually FOIA’d the FDA- to get every reg- FDA-registered mammography machine across the entire United States-
[00:09:44] Adam Walker: Okay.
[00:09:44] Jenica Patterson: To really understand kind of where that access actually breaks down. And so I would say kind of the biggest alarming finding was that there is over about 890 counties in the United States that does not have a mammography machine at all.
[00:10:04] That is bonkers.
[00:10:06] Adam Walker: That’s crazy.
[00:10:07] Jenica Patterson: And if– and if you do the math, I looked it up, there’s a little over 3,100 counties in the US. If you do the math, that’s 30, almost 30% of the counties in the US that do not have a mammography machine, and that’s just talking about a mammography machine.
[00:10:25] Yeah. Like it d- Yeah … like imagine all the other things around surrounding that- Yeah … that limits a woman or a man to be able to get access to that machine to get breast cancer screening. What what else surprised me the most was how clearly access drives outcomes, and I think we kind of layered the capacity of the mammography machine over detection, so of over it, right?
[00:10:48] And we saw which counties with more machines detected more cancers. And it’s not because cancer is more common. That’s not why. It’s really because it was being founded, found earlier in the process, in the screening process, and I think that’s really important to mention. Another surprising finding is that when we did the projections, so we looked at, so if we swapped, if we got the low and no capacity counties if they were able to detect at the same rate at their high capacity, we could project we could catch about 9,600 additional cases of breast cancer earlier.
[00:11:30] And if you look at the map, it’s actually a majority of that is in California or the lower part, lower, like, west part of the United States. So and I just want to mention, I want to give a huge shout-out to the surgeon general of Cal- California. She’s doing a massive work in the maternal mortality space, but also just in women’s health generally.
[00:11:51] So I think there’s a massive opportunity there. So I think that’s– those are kind of the biggest findings I thought were surprising.
[00:11:59] Adam Walker: I mean, that’s shocking. Like 800– you said 890? Yeah. Oh my gosh. That’s like, like… I read– I saw that in the notes, I’m like, “That can’t be right,” right? Yeah. That can’t be right.
[00:12:10] And it is, and that’s, Yep … that’s really unfortunate. So, so Milken’s research also shows that the counties with higher proportions of racial and ethnic minority populations, lower insurance rate, and higher poverty have the worst access. Yeah … for Black women and women of color listening right now, what do you want them to know about why that disparity exists and who is responsible for changing it?
[00:12:36] Jenica Patterson: Yeah. So our research really shows that these disparities are structural, right? So they reflect how access intersects, not just with where the mammography machine is so the geography, but the income, the insurance coverage, the connection to healthcare system. It’s all about that integration, right?
[00:12:57] So when we looked at the counties with lowest detection, they were more likely to have higher poverty, lower insurance coverage, smaller populations, more households with lim- limited English proficiency. And I think that’s really important to share because it shows how these gaps aren’t driven really by a single factor, but really by multiple over- overlapping barriers.
[00:13:19] And I think I’ve mentioned this multiple times, right? It’s not just one single thing that you can solve in the ecosystem that’s going to change. You really have to overcome multiple barriers for these things to be successful. So I think it’s not about individual choices per se, it’s really how the system is unfortunately structured.
[00:13:38] And I think it’s a big responsibility that sits across the system in terms of policy, healthcare, payers, investments, that really all have to play a role. But I think the good news is, as I mentioned, we’re at that inflection point. I think there’s a lot of opportunity for these level challenges to be solvable.
[00:13:57] We just have to address them collectively as an ecosystem.
[00:14:02] Adam Walker: Yeah. We have to recognize them, right? Yep. And then address them, right? I mean, and that’s what we’re doing- yeah … as far as talking about which is so important. Yeah. So, so the Women’s Health Network and you mentioned groups of people, like the Women’s Health Network brings together more than 130 partners, industry, clinical care, research, investment, employers, advocacy.
[00:14:18] Why does it take that many people to the table to move this? And I think I understand- Yeah … why, but I’d like to hear you, like, just verbalize it for me, if you don’t mind.
[00:14:25] Jenica Patterson: Absolutely.
[00:14:26] Adam Walker: Yeah.
[00:14:27] Jenica Patterson: And I want to say we have 170 now.
[00:14:29] Adam Walker: Oh, even better. I love that.
[00:14:30] Jenica Patterson: Yeah. So we just grew.
[00:14:31] Adam Walker: Okay, great.
[00:14:31] Jenica Patterson: Yes. We just announced– Yes.
[00:14:33] We just announced our next cohort of members and moved up to 170 really to get a global, right? Yeah. Get a global perspective. I think one of the key lessons I learned in my previous life at ARPA-H, at DARPA, is you can’t really move the innovation alone by itself. You need an entire group of people and to be able to do this.
[00:14:56] You really need to align across multiple types of disciplines to be able to move the needle And I think in women’s health, it’s really even more critical because these barriers exist at every stage, all the way from the idea, right? The cell models to cl- the clinical trials to, to the market. So I think it’s really an opportunity to pull in this multidisciplinary group to be able to help with every single part of the ecosystem.
[00:15:23] And not just in the ecosystem in the United States. We– Like I mentioned, we just grew globally. So it’s really looking at the entire ecosystem across the world and how we can really solve the problems to be able to move those innovations to reach patients So I think at the end of the day, I think the network is really about integration.
[00:15:42] Adam Walker: Yeah.
[00:15:43] Jenica Patterson: I think we’re bringing all of these actors together to really align around solutions to, to move them forward in a coordinated way.
[00:15:51] Adam Walker: I love that. That’s so good. Okay. So so you’ve also… you’ve said that the central barrier in women’s health isn’t a lack of innovation, it’s a lack of integration, which is what you just said.
[00:16:02] Jenica Patterson: Yeah, I did.
[00:16:03] Adam Walker: So, so let’s talk more about integration for, like, for the general audience. Totally. So like what do you mean by that? Yeah. Like how does that play out?
[00:16:11] Jenica Patterson: Yeah. And to put another plug in I did publish a r- a report about integration from… I had a private session at our Middle East and African Summit in December.
[00:16:24] So take a look at our website, download it. A little bit more about integration, more on the AI and data side.
[00:16:30] Adam Walker: Okay.
[00:16:30] Jenica Patterson: But I’ll talk about integration here from a systems level because I think it’s really important. And I want to give the example of mammography because I think it’s a really good example of in- of integration.
[00:16:43] We see that adding machines is necessary, but it’s not sufficient, right? So you can have all the machines in the world, but you’re still not going to have the access or the education or those multiple dimensions of things that are actually going to get to the patient and the person to actually go and do their screening.
[00:17:05] So it can be availability, it can be accessibility, affordability, accommodation, acceptability. Do you want to go and get radiation done, right? So I think you can add as much infrastructure, but if you don’t address things like transportation to support that woman that lives in a rural community or even a woman that lives in a urban community that needs to take the bus to get to a mammography machine, you need to get that time off work, language access or trust really in the system.
[00:17:36] It won’t work for everybody. So I think I think it’s an opportunity to really integrate all of those things together to really meet women where they are, to be able to support them holistically to get them the care that they need. So when I talk about integration, I really mean about the entire system, really from research as well, like developing that innovation, that next mammography machine, if you will, all the way to reimbursement to healthcare systems that really work together so the innovation can actually reach women.
[00:18:11] Adam Walker: I love that. Oh and I love that you mentioned transportation too, because I feel like that’s something that’s just so easily overlooked by those of us that have access- Yeah … to easy transportation and just forget that so many people do not, and so- Yeah.
[00:18:22] Jenica Patterson: Or even like cost, right? Like you might- Yeah
[00:18:25] have transportation, but maybe it’s not… You can’t afford to take that bus, right? So I think there’s a lot- Yeah … of pieces there. Yeah, absolutely. Now, what do you wish community health advocates, patients, and grassroots organizations understood about how policy and investment decisions actually get made and how ultimately they can plug in?
[00:18:47] Yeah, I think I would love for people to understand that really decisions are made and shaped by data, right? Okay. By evidence. Evidence especially in the regulatory space. If you’re going to get something, an innovation through the FDA, you need to have that evidence. Also, if you want something reimbursed, like if you have an insurance- you need that evidence. You also need clear signals of demand. Like peop- are people actually using this, or are you making a widget that’s sitting on the shelf? So I think from my experience at NIH, at DARPA and ARPA-H, now at Milken, I’ve seen that the most effective change happens when lived experience is paired with clear, actionable data.
[00:19:27] Adam Walker: Okay.
[00:19:28] Jenica Patterson: I think community advocates play an absolute crit- critical role in this when they connect those insights to specific asks.
[00:19:36] Like whether it’s expanding coverage or supporting a pilot or directing an investment, and I think that can move up the chain to make big changes, especially on the government level, right?
[00:19:47] So you have those advocates speak to Congress, and I think that’s where you can move that awareness to action.
[00:19:54] Adam Walker: I love that. All right, so so on the hopeful side, right? Yeah. Not that this hasn’t been hopeful, but, like I’m seeing the progress, and I love the work.
[00:20:03] Yeah. Where do you see the real momentum right now, and what gives you hope that things are going to change?
[00:20:10] Jenica Patterson: I see the momentum at multiple levels. I first want to start off with when I, I started in this field a couple years ago in women’s health the narrative was quite negative, if you will.
[00:20:22] It was like, “Oh, we are under-resourced. We’re underfunded. We don’t have this.” And I’ve noticed that the narrative is starting to shift. People are talking about it in a more positive light. It’s a huge economic oppor- opportunity. There was just a report published from AOADX, which is a company in the women’s health space, about a massive investment opportunity, about all the exits that actually have happened in women’s health.
[00:20:50] So I think it’s a huge shift in, in this narrative, which I think is incredibly important, because when people see that positive momentum, the mi- minds switch in a different way to want to invest, to want to get involved. So I think that’s super important. And I think also we’re seeing more capital flowing in this space.
[00:21:12] I mentioned the AOADX, but I think there’s a lot more public/private collaboration. ARPA-H is, was has just recently put out some programs in women’s health. We’ve seen the federal government and other areas step up in women’s health. We’ve also seen the private sector step up in women’s health, and I think that’s incredibly important.
[00:21:34] I think it’s not really talking about why does this matter, but we’re really focusing on how do we solve this problem and how do we make that shift to know that this is a critical space to get involved in.
[00:21:49] Adam Walker: Yeah. I love that you ma- like, made that differentiation. Like, like, let’s– like, moving beyond why does this matter, like, hopefully we don’t have to convince people why this matters.
[00:21:56] And I think we do have to convince some, but hopefully, like, the, especially those listening understand why this matters. But like, like, what do we do next, right? And that’s so critically important. And I guess that’s kind of my last question for you is for women listening, particularly Black women or women of color that are navigating a system that really wasn’t built with them in mind, what do you want them to do with what they’ve heard and learned today?
[00:22:21] Jenica Patterson: I think I like to leave people with one thing and I think it’s this. It’s that women’s health doesn’t change because of one breakthrough. It really changes with an integrative approach, when policy, infrastructure, community come together to make access real. And so when we get that we don’t just improve women’s health, we really ultimately build a better system for everyone.
[00:22:48] So I would say for people listening, stay engaged, stay informed, and really know that your voice matters because when you bring that information back to your community and you get those community advocates to start speaking, that’s when change happens. And I think that the system wasn’t built with every experience in mind, but I think it has the opportunity with those voices to be redes-redesigned.
[00:23:15] And ultimately, when you’re working through the system, advocate for yourself. Be your number one advocate. Ask those questions that maybe you don’t, maybe you’re uncomfortable to ask. You should ask them, I think, right? Participate in screening where possible and eng-engage in your trusted community. I think those really all play a role.
[00:23:37] And I think one last thing to say is that the system really has to meet you where you are, and I think for us as Milken Institute and us in this women’s health ecosystem, it’s our responsibility to start making sure it does.
[00:23:52] Adam Walker: Oh, I love That’s so good. The what- the system has to meet you where you are, and it’s, it’s women’s responsibility to make sure that it does.
[00:24:00] Jenica Patterson: Correct.
[00:24:01] Adam Walker: That’s a beautiful statement. I appreciate that.
[00:24:03] Jenica Patterson: Thank you.
[00:24:04] Adam Walker: Wow. Okay. That was a great final thought. That was… You’re amazing. The work you’re doing is amazing. Yeah I mean, just you’re doing the work that most people don’t see. You’re building the infrastructure, you’re building the coalitions the evidence base that makes change possible at scale, and you’re doing it with the kind of the clarity and urgency that’s needed in this moment.
[00:24:28] So Jenica, genuinely thank you for the work that you’re doing, and thank you for joining- Thank you … us on the show today.
[00:24:33] Jenica Patterson: Well, thanks for including me. I had a great time.
[00:24:37] Adam Walker: And thank you to our listeners for being a part of this conversation. The health equity revolution keeps moving because people like you and the guests like today’s refuse to let it stop.
[00:24:47] For more resources, visit komen.org/healthequity. And if you or someone you love needs support and you’ve been putting off a mammogram, our breast care helpline is available at 1-877-GO-KOMEN or email helpline@komen.org. This is Real Pink. I’m Adam Walker. Until next time.
[00:25:11] Thanks for listening to Real Pink, a weekly podcast by Susan G. Komen. For more episodes, visit realpink.komen.org, and for more on breast cancer, visit komen.org. Make sure to check out @SusanGKomen on social media. I’m your host, Adam. You can find me on Twitter @AJWalker or on my blog, adamjwalker.com.