On this episode, our guest Dr. Michael Blackwell explains the concept of OneHealth and the importance of caring for both animals and their caretakers to promote wellness throughout the community, with a particular emphasis on services for communities lacking in resources. Family health does not stop at the humans or the animals, but involves both. And this must incorporate mental and physical health care.

A collaborative effort between veterinarians and social workers is important in providing a comprehensive program for long term results and not just a “spot fix”. And this approach has broad benefits to the environment, diseases, and even the current shelter overpopulation problem.

Dr. Blackwell is the Director of the Program for Pet Health Equity in the Center for Behavioral Health Research at University of Tennessee, Knoxville, and is also the Director of AlignCare Health Inc.

Mentioned in this episode:

Keep it Humane Podcast Network

The Animal Welfare Junction is part of the Keep It Humane Podcast Network. Visit keepithumane.com/podcastnetwork to find us and our amazing animal welfare podcast partners.

Hi, and welcome to the Animal Welfare Junction.

2

This is your host, Dr.

3

G, and our music is written

and produced by Mike Sullivan.

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Today, I am so stoked about my guest.

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Um, I met Dr.

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Michael Blackwell this year at the HSUS

Animal Care Expo during a roundtable

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discussion on the topic that we're going

to be discussing today, One Health.

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And it was such a huge motivating factor.

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I'm actually getting chills.

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Um, because it is something

that over time I have seen that

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is needed, that is necessary.

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And that we are just not offering

and we just need to increase this.

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So I am really looking forward to this

conversation and to teaching people

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about the importance of One Health.

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So thank you so much, Dr.

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Blackwell, for being here today.

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Dr. Blackwell: Well, thank you, Dr.

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G.

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I appreciate the opportunity to

visit with you and your listeners.

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Very, very important topic

here that you're covering.

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DrG: So for those of you, for those

people that may be listening who

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don't know who you are, can you let

them know kind of where you started

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and what brought you to where you

are today and your current position?

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Dr. Blackwell: Well, my

name is Michael Blackwell.

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I'm a veterinarian with

training also in public health.

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Um, my career started as a kid

because my dad, uh, was a general

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practitioner, mixed animal practitioner

during, during my upbringing.

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So I've been in the veterinary medicine

world my entire life, um, and, uh,

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of course grew up privileged as a

result of that and being privileged

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in this sense has afforded me the

opportunity to learn a lot of things,

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to experience a lot of things.

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And I've enjoyed a few

careers along the way.

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You know, I thought I would be a mixed

animal practitioner just like my dad.

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Uh, he closed his practice during my

senior year of high school and joined

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the faculty at Tuskegee University

College of Veterinary Medicine.

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So, um, I went back to Oklahoma,

um, after training at Tuskegee

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and, uh, practiced for a few years.

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But during that time, Felt a real

calling to do more than I was able

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to do in my small town in Oklahoma.

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That led to 23 years with the

United States Public Health Service.

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Most of that time with the

Food and Drug Administration.

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My last duty, um, Was a chief of

staff of the Office of the Surgeon

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General of the United States.

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So speaking of those opportunities

and exposures that I got along

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the way, that 23 year career

really did expand my understanding

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of the world as a veterinarian.

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And better understand and how

important our profession is, uh,

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to the well being of our planet.

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Frankly, um, a left active duty with

the United States Public Health Service

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to become dean of the veterinary

college at the University of Tennessee.

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And frankly, uh.

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I took that position because of the

need to focus on public health more than

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colleges were at the time and, , , after

a few years as Dean, , I left that work

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to focus really solely on animal welfare.

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issues.

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, I think like many veterinarians, , I knew

there were these issues out there around

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animal welfare, but, , I was indirectly

connected with them until I got involved

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with sheltering and, , that opened my eyes

even more to many of the issues, , that

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our communities face, our families face.

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So, um, to fast forward, therefore, , it

was the day that A Vietnam veteran's

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dog got euthanized over, , because of a

treatable medical problem, uh, injury.

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And that euthanasia occurred because

he could not pay for the needed care.

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And for the first time in my career,

again, I grew up in the profession.

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I saw euthanasias performed as a kid,

but for the first time, it just seemed

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all wrong that being the nation that we

are, it seemed all wrong that we have

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people who have contributed to our well

being, like our men and women in uniform,

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um, like our public servants, school

teachers and other public servants,

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but often, , not earning a lot of,

, income, but deserving of a relationship

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with a pet, , as a family member.

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And so it was then that I knew I had

to dedicate my, my life to the work

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of improving access to veterinary

care so that all, um, Get the care

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that they deserve to, to, to have.

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And that's irrespective of

their socio economic reality.

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And therein is where it

starts to get interesting.

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DrG: That is a great, that is a

great story because I mean it does.

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It does bring about different aspects.

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Um, you know, I didn't grow up poor.

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I didn't grow up rich, but I grew up

very comfortable, but I grew up seeing

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some of the struggles that some of my

friends and family were going through.

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So I Never look down on them as them

being lesser because they could not

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afford some of the same things as me.

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They were in a different economic status,

but they, they were the same people.

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And I've always maintained that,

uh, somewhat similar to you.

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I, when I went to vet school,

I had a different plan.

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I.

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I thought I was going to be a surgeon,

which I do a lot of surgery, but

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you know, I was going to go and do

a residency or something and, you

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know, kind of playing it by ear

as to where I was going to end up.

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But I started working at a vet clinic

that did a lot of rescue work, and we were

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seeing all of these animals here in, in

central Ohio that were being brought in.

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From rural areas because those rural

areas did not have access to care.

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So then they were dumping into central

Ohio and we were seeing animals that

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were being euthanized or that were

sick or whatever, whatever it was.

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And even the rescue saying, well,

we're, we're getting them out of

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there because if not, they're just

going to get killed down there.

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So it changed my whole perspective

little, and it wasn't overnight.

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It was a little bit, a smooth

transition, but into the need.

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That that these underserved

communities had and kind of led to

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me wanting to do something about it.

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Right.

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So, um, and that's where

that's where I am right now.

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And still.

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You know, working to, to make it better

because to your point, I mean, it is

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important for us as veterinarians to

help both the animals and the community,

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uh, that we're going to be talking

about the concept of one health and

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just in, in very broad terms, but just

from personal experience, I've known of.

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human doctors that will say, Oh

yeah, that's an animal condition.

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You need to talk to your

veterinarian about it, like

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scabies or worms or whatever.

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Like they will not give a, they

will not give a real answer.

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Dr. Blackwell: Right.

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Yeah.

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Yeah.

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And that reflects a

fragmented healthcare system.

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And so when, when I think in terms

of One Health, our work is about.

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Strategically connecting the health

care system so that it's less fragmented

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so that families are being served

holistically and yeah, there are

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those moments when a veterinarian

really needs to be in the room or

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physician, depending on the situation.

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But too often, um, families are sent

down the road, uh, here and there,

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uh, to get care that could be here.

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Packaged and delivered in

a, in a more holistic way.

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DrG: So what is for people that do not

understand what one health means, what

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is the concept of one health and how

does that involve not just veterinarians,

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but other professionals as well?

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Dr. Blackwell: It's a simple concept.

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It's based on the reality

that on this planet.

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Humans, animals share the same environment

as a shared environment or ecosystem.

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And when we are trying to improve the

health of any one of those three, whether

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it's humans, animals, or the environment,

We need to factor in consider all three.

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So if I'm, if I'm wanting to improve the

health outcomes for human population,

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my plans are, are not adequate.

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If I've not even considered the

impact of animals on humans.

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And vice versa.

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But also what their shared

environment looks like.

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So it's not always air and

water quality in this case.

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We often think of, uh, socioeconomics.

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That's an environmental reality, uh,

the shared environment of a family

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based on their socioeconomic reality.

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So, um, that's what One Health is.

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Now to bring that home, when I think

of access to veterinary care, I So as a

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veterinarian, my heart is breaking for

this pet that needs care, and I want to

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figure out a way to get care to that pet.

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But it turns out the barriers to

me being able to get that care

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to that pet are associated with

the humans in the pet's life.

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And so programs that don't address the

human reality are going to come up short.

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In trying to reach the pets

that are currently underserved.

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Um, and so when looking at the

people in their realities, we

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see, while the barriers associated

with them, and that quickly starts

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to clarify their environmental

reality, that's low socioeconomics,

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which is more than limited money.

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It may represent housing insecurity,

food insecurity, language

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barriers, and so on and so forth.

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So looking holistically at the family,

the humans, the animals, and their shared

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environment is what One, One Health is.

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DrG: One of the things that I have

a huge issue with is the whole

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concept of if you cannot afford

an animal, you should not have it.

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Right.

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And, and that is something that

is, that I see more and more,

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uh, recently on social media.

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I was, saw a post where somebody was

talking about subsidizing and affordable

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care and somebody else went as far as

basically saying that somebody that is

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low income is an irresponsible pet owner.

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And in my personal experience, I've

seen people that will go hungry

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just so that their animal will eat.

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I mean, that is a bond.

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That is, that is something that

We don't know because we don't

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have to make that decision.

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If we were in that

decision, what would we do?

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Right?

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So, and that comes down to the importance

of the human animal bond, kind of

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regardless, regardless of the ability of

the person to financially help, , and be

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economically stable, and also not taking

into consideration that that person

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may have been economically, financially

stable when they got that animal,

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and then something happened, illness.

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Work, whatever the reason and now

they're not able to afford that pet.

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So how do we help with that?

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Right?

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So

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Dr. Blackwell: I appreciate the

way you summarize the reality.

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Um, you know, my response to, uh,

that statement is first and foremost,

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acknowledging there's logic there.

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Okay.

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So, okay.

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It's a logical statement by some

measures, but At the heart of it,

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what's going on there is the person

who makes the statement is at risk.

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Of attacking the relationship as

opposed to attacking the problem

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of lack of systems to ensure

everybody has access to health care.

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It's the relationship is not the problem.

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Now, some can be because there are

instances where that relationship should

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not exist, but most often what we're

talking about, especially if it's a

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case of someone with limited means,

yes, the bond often is tighter there.

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Um, even among the unsheltered, they

may be the poster, a poster image of

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the human animal bond relationship.

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Um, and so, is the relationship

the problem, or is it our lack of

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diligence in having systems to ensure

they have access to, to health care?

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DrG: Yeah, I think we, we're always kind

of like looking at something to blame.

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And I think that by shifting the blame to

the person can't afford it, we eliminate.

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our blame of we are not

providing a care that's needed.

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Uh, and, and, and I'm not saying that

to trash on veterinarians because

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we have to charge for our services

and we have to make a living.

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We have bills to pay loans to repay

and everything, but the majority

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of us go into this profession.

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wanting to help animals.

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And I think that a huge component of

like compassion fatigue is going into

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that room and seeing that treatable

condition and giving an estimate and then

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the person saying, I can't afford it.

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I'm either taking my sick animal home

to continue to suffer a poor quality of

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life or die at home, or you're going to

have to euthanize this treatable animal.

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Animal and I mean, it is an knee jerk

reaction to say that person shouldn't

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have that dog as opposed to I didn't

do something to help that situation.

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Dr. Blackwell: Yeah.

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And, and, you know, , Dr.

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G, , veterinary medicine cannot

buy ourselves solely, , fix

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this societal problem.

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, it's bigger than veterinary medicine.

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Uh, so in a sense, we are

victims of the realities that

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that we're talking about here.

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There are a lot, a lot of victims,

the individual needing the care, that

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individual's family, the veterinary

care team, and the community,

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because we're not preventing and

controlling zoonotic diseases when

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they don't have access to care.

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Everybody loses.

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So, What we need to do is work matter

of factly to Advocate for and facilitate

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a system of delivering veterinary care.

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You know, we, we grew up as a profession,

um, largely out of agriculture, but,

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uh, grew a thriving profession based

on a thriving middle class post.

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World War two, uh, middle, the middle

class was growing leaps and bounds and

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more and more discretionary money was in

the pockets of the families along the way.

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The role of the pet in our society

also transitioned or evolved to

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becoming a full fledged family member.

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Now, that's based on the Harris poll,

the latest Harris poll and survey

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and families with pets, 95 percent

considering the pet, a family member.

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So lack of a system and a system that

is built around family health care.

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So, when we, when we change our

perspective and we see ourselves as

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family health care providers, just as

the pediatricians, the geriatricians,

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okay, we're one of the teams taking

care of a family by focusing, in this

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case, on the non human family member.

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By not having that system, then

we're trying to figure this out on

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our own, along with animal welfare.

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Folks, uh, but the money is

not even in the two industries

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to take care of the problem.

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You know, if we look at human health

care and you ask 100 people that you

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meet randomly, do you pay 100 percent

for Your health care and you're

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getting you know, good quality care.

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You may be lucky to find one person, but

most likely out of 100, you won't find

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that person because we as humans rely

on assistance to get our health care.

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It's in the form of insurance.

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Primarily, um, we don't have

enough insurance options for

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families based on the fact that

less than 3 percent of the families

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actually use pet health insurance.

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Hopefully those policies

are going to improve.

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Uh, the finance industry is needed in

this moment because if the policies are

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going to put that family further in a

hole, um, because of a high interest

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rate and so forth, um, and I understand

they've got a crunch the numbers

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and manage their risk and so forth.

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But I'd like to believe that there,

there are better options to be found

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from financing to pet health insurance.

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Now those two things I just mentioned

are not putting that burden on veterinary

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medicine to figure out because we know

how to treat the patients generally

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on a dime instead of a dollar.

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We've historically had to do that.

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Um, It's not even given that opportunity.

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And so yes, when we turn people away,

not having helped them, or we take

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the life of someone they love, and

mind you, we're standing there knowing

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exactly how to help the patient.

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You know, our well being is going

to be undermined every time we

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go through that, that incident.

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And at some point, it's going

to start to, uh, interfere with

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our ability to stay healthy and,

uh, and serve everyone, frankly.

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Uh, so it's a situation of victims all

around and that's occurring because

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we don't have a systems approach.

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And, um, including other industries

outside of veterinary medicine

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DrG: and that, and that is so important.

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I think about, you know, the,

the service that we offer

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with my mobile clinic, right?

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So we'll go to, we'll go to locations.

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We'll do spay, neuter, wellness,

care, and then an occasion.

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There are people that will come in with

an animal that's Horribly injured or

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long term illness and they literally have

no option and we are not the best place

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for it, but we're the only place for it.

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And kind of understanding as veterinarians

that this may not be the best situation,

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but this is the only situation.

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What can I do?

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And I think that we're making a big

difference to those communities.

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Both in in the service that we're

giving and in the education for the

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owner so that they can be better

caretakers for their animals.

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But as you say, it's kind of like taking

care of 1 problem at 1 point in time.

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We are not really fixing

the problem of this person.

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Being able to maintain the

spay, neuter the vaccine.

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Yeah, it got taken care of.

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But how do we make sure that this animal

is fed, that they're on preventive

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care, that they, that they have the

other things that they need to keep

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themselves, other animals in the community

and the people in the community safe.

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Dr. Blackwell: Yeah, you know,

um, with two out of three of

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our households having pets.

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And less than 4 out of 10 have children.

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Family has been redefined by our society

to include human and non human members.

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, So you're more likely to encounter

a family that's a biodiverse family,

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as opposed to a family with children,

, or just, , adults, adult humans.

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And so I start from that perspective,

you know, when I think about,

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well, who is it that we're serving?

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You know, we said we're going to

benefit society and that oath, you know,

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that first line of the oath we took.

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Well, society is.

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Uh, extremely diverse, uh, combination

of privileged and non privileged,

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um, and expectations have evolved

through time because of the, um,

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the place of the pet in our society.

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So even though the laws are still saying,

uh, the pet is personal living property.

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Just like the plants in my office

here, you know, society says, if you

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abuse that pet, you can go to jail.

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They don't care what I do with my

other living property called a plant.

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And so, um, too often.

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I hear 1 of our colleagues say, well, you

know, they're just property under the law.

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Yeah, but we got to be careful

with that one because that's not

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the way the families view it.

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And, uh, and our words and our actions

ought to reflect a sensitivity to

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the fact that we're serving a family.

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And not just an animal, um, when we are

taking care of that patient, um, because

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it's family health and then you bring

in all these other pieces like housing,

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food and transportation and all the rest

and we look at our, our selves today

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and we say, well, where's the system

that was built for these families?

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It doesn't exist.

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You know, there are micro versions

of what needs to happen, but

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we need a national approach.

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Where, um, there's predictability

and consistency to help ensure

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essential services from medical

care to housing, food and so forth

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are available to our families.

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DrG: I think that that that

hits it right on and that, I

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mean, there's still property.

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So why would, you know, why, why

should we care to spend money

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and funds on somebody's property

because we're not seeing it as.

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For the importance that they have, or

for the sentient beings that they are.

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Yes.

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Um, so we have a, there is a disconnect

into the importance of, yeah, as

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you said, what constitutes a family.

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I know that, you know, I have my, my

cats, I have my child, and it's not

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about who I like better than who.

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Sometimes I like the cats better, right?

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But, but my cats are important to me.

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So I don't see them as disposable.

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I don't see them as, you know, okay, you

know, whatever happens is no big deal.

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If somebody injures them, just pay me

what they're worth and I'll be okay.

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It's not like breaking

my TV or hitting my car.

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There is a deep emotional attachment

to our animals as we should have.

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So, so yeah, we have to approach this.

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Much larger.

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Dr. Blackwell: You're not over

interpreting by your own lifestyle

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the word property in law.

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And I think law is going to change

because now there's already a movement

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to have court appointed representatives

for the pets in the justice system,

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uh, often custody, uh, You know,

battles, if you would, or, , people

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leaving estates or something to a pet,

you don't leave property to property.

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So it really, really is important that we

catch up to where society is the law will

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catch up to, but let's not be the ones

that's dragging the process along because,

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and we are at risk of doing that because.

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If you improve, increase the value of

that pet, my liability concerns go up.

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That's real.

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There's a lot of logic and it's

property, uh, liability issues.

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All of that's there.

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But at the end of the day, do

we really want to diminish the

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significance of the human animal bond?

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You know, and we can't have it both ways.

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We really cannot, in my mind, you know, we

either celebrate, honor the human animal

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bond, or we dismantle it, diminish it.

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By uh, treating the patient as

mere property of no consequence

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anymore than a chair back home,

well, a chair, a plant back home.

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'cause a chair is not living

property, but a a, a plant back home.

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And we know that's, that's

not the way society works.

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We just cannot run certain realities

that we're confronted with.

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DrG: Yeah, I was gonna say I'm taking

a companion animal law class and

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one of the things that they discuss

in some of these court cases is the

373

concept of opening up the floodgates

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to litigation, if we make animals not

be property, because right now, again,

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if somebody harms an animal or an animal

is harmed, yeah, if it's cruelty to

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animals, then that's that's different.

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But then other than that,

they're just property.

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Well, if we don't consider them

property, then what is going to

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be added and what kind of, uh,

lawsuits or other filings can happen?

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Because now we are harming a

living being instead of just

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damaging somebody's property.

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Dr. Blackwell: Mm hmm.

383

You know what I think is going to happen?

384

I think, , by the end of the decade,

70 percent of voters or eligible

385

voters will be millennials and Gen Z's.

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Two generations that have adopted

the bonded family, we call them

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lifestyle, human animal bond

related or associated family unit.

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Um, I fully expect that laws will start

to be changed, public policies will

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be adjusted because let's just take

government, for example, a government

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program that is intended to support the

health and well being of families at risk.

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will not have the luxury of ignoring

the presence of the non human

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family members in the household.

393

You can't possibly do a good job and

the families are going to demand that

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programs get adjusted accordingly.

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, we might think that, well, you

know, the middle class probably

396

wouldn't go along with that.

397

But when we look at the socioeconomic

trends in the country, our

398

middle class is still decreasing.

399

While we're seeing, uh, an

enlarging of the working poor

400

class of families in our country.

401

So I look down the road and I'll look

at what the potential is for change

402

and oh, let's not place this strictly

on compassion because why would

403

the government have to be concerned

public health, the lack of prevention

404

and control of zoonotic diseases.

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In the face of climate change.

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Where we can predict, , larger

populations of vectors, , growing

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populations of microbes and new

microbes entering the picture and new

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communities and to not have a more

robust system to ensure availability

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of health care for those pets means.

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A national security threat.

411

So I look at it from that standpoint.

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And for that reason, I, I see it as

existential as an existential crisis,

413

much like climate change is just

cannot be ignored and treated the

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same as we have been and currently

still are, for the most part.

415

It will be to our detriment as a nation.

416

DrG: I think, you know, we also

kind of have to start with schools.

417

And like you said, you know, you

want it to be part of the school

418

to change the way that things were.

419

And I think that we have to

change the mindset of the

420

veterinarians that are graduating.

421

And even not just the mindset, but

even the pool that we're drawing from.

422

Because, you know, like here

in Ohio, for instance, uh,

423

we made a map of the deserts.

424

The places in Ohio that

lack veterinary care.

425

And the majority of those are

also lower income communities.

426

There's no resources as far as

food resources or pharmacies,

427

doctors, like there's just a void.

428

And then I saw the class that

for this year for the vet school,

429

and it has students from many

counties throughout the state.

430

And you know, which counties

are not represented.

431

Those deserts.

432

Dr. Blackwell: Yeah, I was

going to say, let me guess.

433

DrG: Yeah, right?

434

And, and I think that that in itself is a

huge problem because I feel that if you're

435

not from, from a certain area, if you

don't grow up in a certain culture, you're

436

going to have no interest in going there.

437

Right?

438

Like somebody that grows up in

central Ohio is not going to

439

want to go to southeast Ohio

to live or to work or anything.

440

Right.

441

There are places.

442

again, devoid of resources, not

just veterinarians, but there's,

443

there's not much happening there.

444

So who is going to go work in these

places that have no resources?

445

Well, we need to perhaps start taking

kids into a school that are from those

446

areas because they are more likely

to go back and help their community.

447

But then we also face the challenge that

Who are the role models to these kids?

448

There's no veterinarian to work.

449

When I was in high school, I

went to work for a veterinarian.

450

I knew what I wanted to do,

but I needed the experience.

451

And I went to the veterinarian, I had

two amazing role models, and then that

452

took me through to where I'm at today.

453

Who is the role model for veterinarians,

technicians, for anything in

454

these underserved communities?

455

Dr. Blackwell: Yeah, this is, uh, this

is why, , there still needs to be ongoing

456

discussions about people who've been

left behind, marginalized communities.

457

Middle America is filled with

these kinds of communities, uh, the

458

flyover communities of the country.

459

As far as academic veterinary

medicine, we have a passive system.

460

I often say without doing a thing,

we just simply open our door and

461

there's a long, long, long line

of people wanting to come in.

462

You didn't do a thing to

get that line to form.

463

So by being able to sit back and

just let this passive system work.

464

Well, what happens is you get

the privilege showing up and

465

that's not a slight on them.

466

It's just simply saying what comes

with privilege is the ability

467

to go to a professional school.

468

You know, I think of these young

people who grew up in some of our

469

rural communities and not necessarily

the strongest school system.

470

And this is across race.

471

It's not necessarily a minority

thing here in this case.

472

, they're disadvantaged.

473

They're not privileged, , in the

same sense of someone who grew

474

up in a thriving, uh, suburban

community with strong school systems.

475

So academia, yeah.

476

If I were King for a day would become

way more strategic and proactive in how

477

we fill those seats because it's only

through that process that we're going to

478

get the representation that you spoke of.

479

Otherwise, we will continue to lack

cultural competence because we'll

480

just a bunch of privileged people

who are doing the best they can

481

and trying to know and understand.

482

Unless you walk that walk,

you know, live that reality.

483

Maybe you don't know really what

it's like to, to serve a community

484

that that's, , marginalized.

485

Let's just put it that way.

486

.

DrG: I love that you just brought up the term of cultural competence,

487

because I feel like I've been yelling

that for the last year and it's mostly.

488

There are, there are quite a few

people that see what we do and they,

489

they talk about wanting to reproduce

that kind of system as far as the

490

mobile affordable and accessible care.

491

And they always ask about, you

know, what, what we're doing.

492

And I say, what we do, we have a certain

number of surgeries or procedures or

493

spots that we can do, but we leave it to

the community to tell us what they need.

494

Right.

495

Uh, my, my niece is a psychologist,

uh, down in Florida and she works in,

496

in Miami with, with different groups.

497

And I interviewed her actually

about the human animal bond

498

from a human perspective.

499

And she brought up the fact that we

have to bring care and assistance that

500

is necessary and that it is accepted.

501

If those things are not met,

then we're just self serving and

502

we're doing it for ourselves.

503

Then it's that savior, hey, I went

in and I helped all these people.

504

But are we helping?

505

Because...

506

You know, they say you can take the

horse to water, you can't make it drink.

507

Well, I can take my truck down to,

to a certain community and say, Hey,

508

I'm, I'm sterilizing dogs today.

509

But the community doesn't need

nor want their dogs sterilized.

510

Am I helping anything?

511

I am not.

512

So we have to, we have to listen.

513

We have to understand.

514

And that's where that, that diversity

of students is going to help.

515

Because again, you don't know

what someone needs unless you,

516

you grow up in that situation.

517

You understand the needs

and you can provide it.

518

In a, in a proper way.

519

Dr. Blackwell: That's the strongest

argument for diversity in this profession,

520

or in any, in any sense, because, um,

you know, I, I sometimes say, um, I

521

asked the question, can a 100 percent

white profession serve a diverse nation?

522

Theoretically, yes.

523

But practically, based on, um, a historic

perspective, that's probably not going

524

to happen, and for practical reasons,

for logical reasons, again, this logic

525

thing keeps getting in our way, that's

why we call them a paradox, you know.

526

Um, so, uh, not being culturally

competent is one of our limitations.

527

Um, and being more of a privileged

crowd, we are even further removed

528

from being culturally competent.

529

You know, um, Dr.

530

G, you can take a dart and throw it

at the United States map, and you

531

can throw it 100 times, 1000 times,

and no matter where it lands, We

532

don't even know the distribution

of diseases in that community.

533

Why?

534

We've never wanted the measures.

535

We did not advocate for

these measures to be taken.

536

We don't, we can't, a community cannot

plan for needed services because

537

they don't even have an understanding

of their own needs in some cases.

538

But we start by trying to understand

what they understand about their

539

needs, as you were saying a moment ago.

540

And then help them to move to a

different level of understanding

541

if that seems to be, uh, needed.

542

But we shouldn't be in the 20th

century and can't hit a community

543

in this country and not know the

distribution of the diseases.

544

You know, what are the top 10?

545

We can take national data from big,

big data databases, um, And we can do

546

a guesstimate about that, but there

ought to be more precision than that.

547

We have the capability as a nation.

548

And again, veterinary medicine

doesn't even have to do it.

549

We just need to advocate

for it being done.

550

There are public universities across

the country with students who would

551

welcome these kinds of projects.

552

And it wouldn't cost the profession

anything, but we want, we have to want

553

to know, we have to be curious enough.

554

For whatever reason, to advocate for

these measures to be taken, um, and,

555

and on the human side, especially from

a social service perspective, there

556

are all kinds of survey instruments

that are being utilized to understand

557

communities in order to make plans.

558

There's a healthy people's strategic

plan of the nation with social

559

determinants of health being discussed.

560

What are those key

leading health indicators?

561

If we are the full fledged medical

profession that we are, you,

562

you would think that we would

be mirroring or looking somewhat

563

like, uh, healthcare in general.

564

So when I talk about fragmented

healthcare, we are really disconnected

565

from how health care works, including

the fact there needs to be a systems

566

approach and that it's family health care

made up of an interprofessional group of

567

disciplines or people and organizations

and not the sole proprietorship

568

that operate under their own roof.

569

And they don't share any information.

570

They don't receive much as

far as being in a system.

571

So I keep going back to that

systems thing, because I think

572

until we have that in place, we

won't achieve cultural competence.

573

DrG: So one of the important things about

this is the inclusion of the social worker

574

into the veterinary care, and that's

one of the things that I'm looking into

575

and wanting to add to our services as

a way to provide more long term care.

576

So can you discuss the role of the

social worker in, in In conjunction

577

with veterinary medicine for the short

term problems, but then in helping

578

that that family continue to care

for themselves and for their animals.

579

Dr. Blackwell: Yeah.

580

Okay.

581

Um, thank you for the question.

582

So let's establish the context.

583

Again, the context is.

584

I, as a veterinarian, can't do

what I've dedicated my life to

585

do because of human realities.

586

Now, I can either go back to school

and learn things about communicating

587

in difficult situations and diffusing

things and, and I can leave the practice

588

and I can go out and help my client get

these other essential resources, or I

589

can choose to partner With a profession

that actually exists for those reasons,

590

you know, social work is a very, very

important profession at the heart of it is

591

meeting people where they are and helping

them to get to where they need to be

592

resource wise and so forth,

connecting them with needed resources.

593

Um, while I was with the office of

the surgeon general, we were often

594

talking about disparities and help.

595

And I was shocked when I learned that the

number one reason that families were not

596

accessing services in their community was

that they didn't even know Either that the

597

services were available to them, or they

didn't know how to navigate the system.

598

Well, veterinary medicine is,

we've got our plates full.

599

We need to be focused on

what we're trained to do.

600

But we ought to care enough about

the client that we're serving in that

601

veterinary client patient relationship.

602

That we would want to be in a One

Health system where somebody is

603

attending to our client's needs while

we take care of the client's family

604

member, the non human family member.

605

So social work is that, that profession,

foremost profession, and finding,

606

linking people with needed resources.

607

Veterinary social work was started

here at the University of Tennessee

608

in 2002, while I was dean, because we

wanted Social workers to get additional

609

training in how to support the

humans where pets are in the picture.

610

So a simple example, if a social worker is

trying to address a housing situation, so

611

either the person is already on sheltered

or they are insecure in their housing.

612

And they're doing that work without

considering the non human family member,

613

they're not doing the job that the family

actually needs their help with because

614

they've left out a family member, uh,

so rather than spending time trying

615

to line up housing, where the policy

won't even allow the pet to be there.

616

Or maybe they have a pet policy, but

there are some other policy related

617

matters that represent a barrier.

618

Um, what a veterinary social worker

would do is not make that mistake.

619

Because they're going to be

factoring in the presence of the pet.

620

They also, by the way, though, attend to

the human needs, even around livestock.

621

So, when a family loses, um, Their flock

or herd or whatever due to the population

622

because of a terrible disease or whatever.

623

There are huge mental health impacts

on that family and , there hasn't

624

been historically that system

to attend to the family's need.

625

So veterinary social workers would

be that special discipline within

626

social work where additional

training has been acquired.

627

And how to work with families where

animals are part of the picture.

628

DrG: I really like the inclusion.

629

Uh, I interviewed, , Alicia Kennedy from

Australia and she is an amazing woman.

630

And she, she was talking about the

importance of the social worker as

631

she helps primarily seniors, but

in how it helps along the whole

632

way, like you brought up the, the

mental health aspect, we just.

633

Think about the, the economic aspect or,

you know, even the housing aspect, but

634

we don't think about the emotional toll

that it takes on that person to not be

635

able to provide the help or if the animal

needs to be euthanized because it's at

636

that point in life, how difficult it is

for that person, like you're going to

637

euthanize their, their dog or their cat.

638

And then this person, especially

in her case, the elderly,

639

They're just going to go home.

640

It's like, okay, well, I hope you're okay.

641

Um, you know, like there's,

there's nothing else.

642

And as veterinarians, there's

not much for us to do.

643

I mean, what do we do?

644

We just send a sympathy card

and, and hope that that's okay.

645

But what, what can we do?

646

We're not trained for that.

647

So I think that that is an amazing place

for social workers to just take, take

648

one where the veterinary work ends.

649

Take on the human aspect from there

and just kind of complete the circle.

650

Dr. Blackwell: Yes.

651

Yes, because, um, you know, I,

I also often comment on the fact

652

that when someone is in crisis

when humans are in crisis, we are

653

emotional one way or the other.

654

And when we're emotional,

we're not always logical.

655

We certainly don't always.

656

communicate in the most, um, , I

guess, straightforward way.

657

Um, it's human.

658

It's human reality.

659

And I tell you, the veterinary social

work thing, uh, my vision for what became

660

veterinary social work actually started

while I was in practice in Maryland.

661

Before I became Dean at Tennessee, and

I had a good clientele, um, very middle

662

class clientele, every now and then,

um, lower income people, but it was

663

during that practice that I recognized,

oh boy, this is not my dad's veterinary

664

practice world, you know, people had

changed, you know, the bond was so on

665

display all the time, and I was As chief

of staff, we were working on the first

666

surgeon general's report on mental health.

667

And so suddenly, or gradually, really, I

came to appreciate how often I had been

668

looking across that table into the eyes

of depression and anxiety or anxiety.

669

I felt so inadequate in that

moment because I always prided

670

myself as being a people person,

as really serving my clients.

671

Having those conversations that

around end of life, uh, addressing

672

the guilt, but coming out of not

a formerly trained perspective.

673

So, uh, social work, veterinary

social work grew out of a realization

674

that we were way in over our

heads there and we needed the.

675

The allied profession to be there with us.

676

Uh, that would safeguard the mental health

of the of the veterinary care team as

677

it safeguards the health of the family.

678

DrG: I recently spoke in my last

podcast about the concept of no kill

679

and how people are really upset about

the number of animals or the, the

680

percentages as far as no kill and, and

one of the things is that I think that.

681

The perspective is in the wrong place.

682

We're seeing the euthanasia is the problem

and it's not the problem is the result

683

of a problem and everybody is like, well,

to to fix the euthanasia number, then we

684

just need to release animals that are not

altered and we need to adopt to everybody.

685

And we just need to have

better policies and not intake.

686

And that's not fixing the problem.

687

That's not closing that that

spigot so that it doesn't

688

keep putting water through.

689

Right?

690

And it's not

691

Dr. Blackwell: Oh, that's mopping

the floor and not turning off.

692

DrG: Right.

693

Exactly.

694

Because, I mean, I, I struggled a

little bit with the, with the subject

695

of that podcast because I don't want

to come off as being pro euthanasia

696

because that's not the point.

697

My point is we have to understand that

euthanasia is just an end result, and

698

we need to take accountability for

how these animals are ending up in

699

shelters, how these animals are ending

up in these situations, how people are

700

ending up having to relinquish their

animals, or Not even relinquishing the

701

animals, they just have unsterilized

animals because there's no access to

702

spay and neuter services, so then their

large dogs are having all these puppies,

703

and where are they going to end up?

704

I think that, you know, in looking at

the whole, how do we fix the shelter

705

problem, this is a huge way, like, one

of the many things that we need to help

706

that shelter problem, is to keep them from

ending up at the shelter to begin with.

707

Dr. Blackwell: Yeah,

and in order to do that.

708

Just as I believe companion animal

veterinarians are actually in the

709

business of family health care,

shelters are social service agencies.

710

Their work is as important

outside of those walls.

711

As it is inside of the walls

and and yet historically.

712

It's been inside the walls that

the problem is being addressed and

713

we're really just mopping the floor,

, without turning off the spigot.

714

So, culturally shifting

to a social service

715

.

Foundation, uh, brings with it what all social services, social service

716

agencies do, and that is being connected

with the system in one way or another,

717

usually in multiple ways, because, yes,

if you, if you don't stop them from

718

coming in, and let's just say what,

what are some of the common reasons?

719

Well, uh, the family, uh, the, the, the

pet has a medical, , need family can't

720

find an option in the community

and they come to the shelter for a

721

solution, which too often involves

relinquishment, um, but the family is

722

hoping that their loved one get some help.

723

They're not necessarily just

discarding someone they love.

724

Um, I mean, all you got to do is spend

a little time in an intake area of

725

a shelter and just see the, the, the

emotional trauma that's going on there.

726

So, , Going back to cultural

competence, if the profession is

727

going to become culturally competent,

it's not just understanding the

728

community, but understanding what

our role is toward the community.

729

As family health care providers,

cultural competence for shelter is

730

not just understanding the community

but understanding again how to work

731

with that community outside of those

walls in order to address the problem.

732

DrG: Yeah, I think that You know,

it's, it's kind of, I think of,

733

it's a simple problem with a

very difficult solution, right?

734

It's kind of like the best way to say it.

735

It's like, we know, we know what

needs to happen, but there's so

736

many things that need to come.

737

Together to be able to do it and

and to your point at the beginning

738

of this of this conversation is is

not just a veterinarian problem.

739

We just have part of the problem.

740

It's not just a society problem.

741

It's not just a physician's problem.

742

We all have to just.

743

Come together into the concept

of one health and take care

744

of everything together.

745

Dr. Blackwell: Yes.

746

Yes, and I hope I hope Those who are

listening to to this podcast And in our

747

individual conversations that we become

advocates for the development of a

748

systems approach and that needs to be a

one health System that's when veterinary

749

medicine will be able to do a better job

of reaching those underserved individuals.

750

We just have no other choice but

to work with others to address it.

751

It will be to our detriment

to not have such a system

752

formed very quickly, actually.

753

Um, do I have optimism?

754

Yes.

755

Because again, I think the public health

issues and which include mental health,

756

by the way, is not just physical health.

757

Um, these are going to be big

drivers for change out of necessity.

758

And, uh, I fear that we

may might be dragged along.

759

I'm hoping we're not being dragged along,

but rather we're like, you know, on the

760

front line helping to make this happen.

761

DrG: Anybody that's listening that

wants to learn more about One Health

762

and about veterinary social work

and about the things that we need

763

to do as a community to do better

for our pets, what kind of resources

764

would you recommend that they visit?

765

Dr. Blackwell: Well, they can

certainly go to our website at, uh, P.

766

P.

767

H.

768

E.

769

Paul Paul Henry Edward dot U.

770

T.

771

K.

772

dot E.

773

D.

774

U.

775

U.

776

T.

777

K.

778

University of Tennessee, Knoxville.

779

Yes.

780

Um, besides that, uh, there is a lot of,

uh, besides our website there, there,

781

there are a lot of other resources.

782

Uh, simple Googling will get you to a lot

of those resources, uh, of information.

783

Unfortunately, there won't

be a whole lot around.

784

Systems that we've been working on

a system called the Align Care and

785

you'll find information there on Align

Care, but we need more thinking about

786

a systems approach my interfacing

with the human health care community.

787

They are ready, they, they see the same

problem from their, their perspective,

788

even though they don't understand it

from the veterinarian's perspective.

789

So I think.

790

Time is ripe, if you would, for a system

to start to be formed in a larger sense.

791

DrG: Excellent.

792

Well, this has been an

amazing conversation.

793

I'm so happy that I got to spend this

hour talking to you, and I hope that

794

everybody that's listening understands,

has a better understanding, and a little

795

bit less judgment of those individuals

who perhaps cannot take as good care

796

as we think they should be, because

it's also a matter of perspective.

797

Um, but, but yeah, you know,

thank you so very much.

798

And I hope to talk to you again at

some point and, and if anything, be

799

able to share some of the, some of

the things that we can do and get your

800

information on how we can do better.

801

Dr. Blackwell: Well, thank you

for allowing me to join you

802

today and have this conversation.

803

Very, very important one, so I appreciate

the work you're doing because we, we

804

do need people like yourself who are

carrying the messages forward and out

805

there and stimulating the thinking.

806

Thank you for all of that and I wish

you the best as you continue your work.

807

DrG: Thank you so very much.

808

Well, for everybody that's out there,

take care of yourself, take care of

809

your animals and thanks for caring.