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Hello and welcome to Modern CEO! Im Stephanie Mehta, CEO and chief content officer of Mansueto Ventures. Each week this newsletter explores inclusive approaches to leadership drawn from conversations with executives and entrepreneurs, and from the pages ofInc.andFast Company. If you received this newsletter from a friend, you cansign up to get it yourselfevery Monday morning. For all the talk about the rise of “the user”user-generated content, user-centered designit is rare that users (aka patients) are actively consulted in health innovations, especially in communities that lack access to basic healthcare. Innovation must be designed with and for the people it serves, harnessing the insights of those who best understand their communities needs, Jennifer Gardy, deputy director, global health, at the Gates Foundation, told me recently. Imperfect pipe dreams Gardy says she understands why global health advocates, often optimists who want to improve outcomes, can sometimes engage shiny thing-itis, as she calls it. Well see this cool new technology and well say, This is so cool. If we build it, they will come, she says. Unfortunately, without community input, those innovations often fall short. In 2011, the foundation initiated a program called the Reinvent the Toilet Challenge. Some 3.5 billion people worldwide lack access to safe sanitation, which puts them at risk for diseases such as diarrhea, typhoid, and cholera. (To draw attention to the challenge, foundation cofounder Bill Gates went on The Tonight Show Starring Jimmy Fallon and convinced the host to drink water made from treated sewage water.) During field testing of the earliest designs, research teams heard from women and girls in their communities about their health, safety, and privacy. They highlighted poor lighting and lack of menstrual products. As a result of this and other projects, the foundation launched a genderintegration effort. Now all foundation teams are trained in applying a gender lens to their work. Whether its developing a team-level guiding strategy that includes gender considerations or filling out a gender intentionality assessment for every investment we make, thinking about the impact (and unintended consequences) on communitiesespecially women and girlsis now baked into the fabric of how we operate as a foundation, Gardy tells me in an email exchange. Gardy also shared some of these insights during a Fast Company panel produced in partnership with the Gates Foundation during the CES tech trade show earlier this month. The Gates Foundation, whose mission is to create a world where every person has an opportunity to live a healthy, productive life, participated in CES to showcase some of the health technologies it has supported. Innovation through community The call for more community input in innovation was echoed by panelists Laura Adams, senior advisor at the National Academy of Medicine, and Greg Simon, president of Simonovation, a science and tech policy consulting firm. Digital health is about giving people access to the information that they ought to have anyway, says Simon. The gripe I have with the digital medical community is that they stopped talking to patients, he adds, and instead collect data without understanding the human context. Thats a shame, as research suggests patients can be an asset in health innovation. A 2015 study of patients with rare diseases found that more than half had developed their own solutions for coping with their diseases, with 8% coming up with tactics that were truly novel. Adams also notes that if patients arent consulted on health innovation, theyll likely take matters into their own hands, adding: I think the sleeping giant is AI (artificial intelligence). We have no idea how far AI will take the empowered patient. She cited the example of a frustrated woman whose young son saw multiple physicians, none of whom could diagnose the cause of his chronic pain. She supplied ChatGPT with information from her sons MRI reports and other health data. The chatbot suggested a diagnosis of tethered cord syndrome, which was confirmed by a neurosurgeon. And as generative AI tools become an increasingly important part of the health landscape, Gardy urges innovators to tap into communities to make sure they have representative data as they build their models. You have to have lived experience part of your development process, whether its an AI-based tool or a better community toilet, she says. I asked Gardy what CEOs and other leaders can do to support the mission to create a world where every person can live a healthy, productive life. She replied: I hope more business leaders, corporations, and tech developers embrace health innovation for all as a smart investment and seize the opportunity to improve lives and livelihoods around the world. How does your company support health innovation? Does your company support health innovation? If so, how do you engage communities to ensure that your product meets the needs of patients? Send your comments to me at stephaniemehta@mansueto.com. Id like to share some of your insights in a future newsletter. Read more: healthcare innovation 8 next big technologies in health Mark Cubans audacious cure for high-priced drugs Fast Companys most innovative healthcare companies for 2024
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Everyone needs their vice. For me, its tacos. Tacos and a cheap can of beer. But each January, the tacos hit differently because the beer is gone. Ive been Dry Januarying for longer than I can remember, and will be the first to praise the hashtag. Over time, mine has extended to February, March, and now through most of the year until the Midwest grows cold and the parties feel cozy. The annual reset offers me a health tune up, and a cessation of habitand thats true for up to half of us who report that Dry January curtails drinking longer term. A glass of champagne or the occasional paloma gets swapped for seltzer and a splash of juiceor god forbid, tap water (*shivers*)and I cease reflexively grabbing something alcoholic to celebrate a hard days work. Whereas I used to quietly mainline homemade gingerade for the month while sidestepping the judgement of friends, the big brandification of sobriety means that my local liquor store eagerly emailed me on January 1 this year, inviting me back to try their Willy Wonka assortment of non alcoholic beers and spiritswhats been estimated as a $13 billion global market in 2023 and growing. NA drinks were once a mark of shame, but now theyre the popular kids, with enticing flavors, sharp labels, and a tempting, ever-so-sanctimonious halo effect of self-care in an era when we should know better. Any level of alcohol is bad for you, notes Daniel Roche, echoing warnings from the former Surgeon General. Roche is an assistant professor at the University of Maryland School of Medicine who studies alcohol and nicotine addiction. Going back 10 to 20 years, there was still some argument that there might be some benefits of alcohol, but now, any level of consumption is associated with almost every cancer. [Photo: Anheuser-Busch] At face value, the NA movement is a boon for health. But Ive also had the creeping suspicion that its too convenient. This is the first Dry January where Ive found myself chipping away at a 12-pack of (NA) Budweiser, its white and silver cans glinting in the light like vermeil clydesdales. Ive been enjoying the bite of hops chasing a rich al pastor, my palate convinced that Im drinking the real stuff, to the point Ive been asking myself if I should run back to the store to grab another pack. I havent had a drop of alcohol in weeks, but I still wonder: Am I really giving up drinking this month, if Im still drinking beer? Am I breaking any habit if Im reaching into a cardboard box labeled by Anheuser-Busch InBev? The answer is maybe. And maybe not. Through conversations with half a dozen addiction clinicians and researchers, experts firmly agreed that the proliferation of non-alcoholic beverages pose a net gain for public health. But they generally concurred that I may be onto something. There is little known about how non-alcoholic beverage affect our long-term relationships with drinking, and they could come with risks of their ownnamely, keeping us dependent on the rituals of alcohol at the opportunity of breaking up with it entirely. We’re still sorting that out, says Kenneth Leonard, director of the Research Institute on Addictions at University at Buffalo, noting that anything that cues the sensations of alcohol might lead some to seek the real thing. It could certainly elicit some interest in returning and having an alcoholic beverage, and maybe saying, I can just have one, or maybe I can have a couple. Our changing treatment of addiction To reiterate, the experts I talked to ranged from ever so positive to quite bullish on the proliferation of non-alcoholic products. While many shared light, curious concerns, they agreed that anyone from a light drinker (consuming 1 to 2 drinks a day) to a heavy drinker (who consumes 4 to 5) might benefit from trying them. The key reason for their support is that the medical communitys approach to addiction has shifted over time. Traditional programs like Alcholics Anonymous (which did not respond to comment) coach the complete cessation of drinkingwhich has often even included non alcoholic beers, in case they might trigger a relapse. But over the past few decades, clinicians have softened their approach in treating addiction from abstinence to whats known as harm reduction. I think in the clinical world that there’s recognition that people are not going to change in ways they don’t want to change, says Leonard. You have somebody come in for treatment for an alcohol use problem, and they say, I want to cut down on my drinking, you know, a clinician is not going to say, well, I’m only going to treat you if you’re committed to abstinence. Even though abstinence is the ideal long-term outcome to most clinicians, they acknowledge human nature, and will take what they can get. If an NA drink swaps out just one alcoholic drink, they are less concerned about the potential for unknown, long-term consequences than this singular net gainand having a patient take a first potential step in a greater path to recovery. The science has progressed at this point, says Joel Sprunger, a clinical psychologist in the addiction sciences division at the UC College of Medicine. If I can get somebody to go from drinking a 12-pack a night to six-pack a night, it’s still a lot, but it’s half. Being able to make that change can build momentumlet’s cut it in half again. Now I’m going to go from six to three, and then from three to one, and then maybe I don’t need it after a while. The science of habits Breaking an ddiction to ethanol is particularly difficult, but all new habits take time to form: an average of 66 days (though as many as 258), according to a landmark study published in 2009 that followed nearly 100 people as they charted new behaviors in drinking, eating, and activities like running. Phillippa Lally, who is now the Co-director of Habit Application & Theory Research Group at the University of Surrey, was the lead author on this study. And she is quick to caution, per her own research, that the single month of January wont be long enough for many people to break any habit. However, as for the effect of swapping a beer for an NA beer, she believes it could actually be beneficial to cut back consumption long term. You cant easily break a habit . . . particularly not just by consciously stopping yourself from doing it. It takes effort every time. So, you could exert this effort for the whole of January and then stop and you havent broken the habit, Lally writes via email. Substitution is a potentially useful approach to break a habit: Form a new habit that is stronger than the old one. Choosing a substitute that meets the same goals as the original habit is also a good idea, so a NA drink is a potentially good approach to that too, because it meets the goal of having a drink, potentially of being social, of the enjoyment of the flavor (presuming you do enjoy the flavor). In psychological theory, Lally is correct. In the actual practice of consuming alcohol, she might not be. A study from 2022 tracked beer purchases across 64,280 British households over three years. It asked the question that we are now: Do low and no ABV beers reduce our drinking? In this study, alcohol alternatives were consumed in small overall amounts at a population level: regular beer outsold NA beer at a rate of 32:1. But what it found was striking, and you can see it for yourself on the timeline below. Once households started buying nablab (no and low alcohol beer), they did consume less alcohol overall. Nablab purchases offset 22.5% of regular beer drinkingand that shift in habit continued even a year later. But they also kept on buying normal beer, albeit not as much. (Its also worth noting that another study looking at no and low-alcohol beverages in Great Britain and Spain found little benefit in their consumption: These lighter options were linked to lower mortality rates, but at such low levels it was a moot intervention.) Graphic from Are Lower-Strength Beers Gateways to Higher-Strength Beers? Time Series Analyses of Household Purchases from 64,280 British Households, 20152018 by Eva Jané Llopis, Amy ODonnell, Eileen Kaner, Peter Anderson [Image: Oxford Academic] In other words, NA drinks appear to reduce consumption by someone who drinks, potentially long term, but they arent a proven gateway to full sobriety, either. People who started drinking NA beers were still drinking the same, diminished amount of alcohol from the first day they bought an NA beer to a year later. While the studys author did not respond to request for comment, Roche is bullish on the findings, and says he could imagine those nablab drinkers really could kick the habit longer term, but that we dont yet know. His take on NA drinks is optimistic but measured. I don’t know that I would come out and say I fully support it, but also I’m not strongly against it either, says Roche. I think, you know, having more options available to people as they make more informed decisions about the role that they want these beverages to play in their lives is a good thing. Indeed, one study found that simply by expanding the number of different NA options available next to alcohol increased their rate of purchase. So the proliferation of NA drinks itself likely means more of us will be drinking them. [Image: Ghia] Breaking the links between drinking and our identity Yet I cant help but wonder if drinking these convincing mocktails or NA beers is only perpetuating our identity as drinkers. And thats a point that could make you stick with a habit you might otherwise try to kick completely. There is . . . a question of identity here, writes Lally. If people identify as doing dry January, then they are likely to drink again in February. Whereas if they identify as someone who no longer drinks, or drinks rarely, its more likely to stick, but that is likely harder to encourage people to. Could the same be true to someone who still cracks a beer with their tacos? An alternative approach, Lally notes, is to remove cues that lead us to drink, whatever they may be. If these are removed permanently then the change should stick, she continues. However, a lot of the cues are things we cant remove from our lives. Indeed, alcohol is closely associated with every major social activity for adultswhich is both cultural and the result of omnipresent marketing (see: the NFL). Whether we’re talking about dating, whether we’re talking about picnics or end of year parties or retirement parties or all those things, there’s always celebrations, says Leonard. There’s wine, beer, champagne, all those opportunities. And so you have to sort of imagine, what would those events be with[out alcohol]. You know, maybe they would be fine. The researchers I spoke to agreed that throwing back a few NA drinks at a party was a healthy behaviorand it might even help you deal with social anxiety. If you strongly associate beer with being a social lubricant, well, studies show the placebo effects may come along with it. You may actually get chattier and jollier drinking NA beer. But I think eventually, that’s going to peter out well without the drug on board, says Roche. And your association between celebration and consumption may naturally fizzle out, too. In traditional conditioning models of learning, you have a conditioned stimulus, which is beer, and you have an unconditioned stimulus, which is alcohol. The way you extinguish that is, you present the beer cue without the alcohol. And then that should weaken that learning of this really positive, associative factor [of a buzz], says Leonard. But we don’t have the data on that. [Image: Athletic Brewing Co.] What else can we do after dry January? If youve read this far, then you might be wondering, what other actions either you or the industry at large can do to reduce the consumption of alcohol. In fact, we do have some data on just that. For the industry, one study has calculated that, if the producers were to reduce the ABV in drinks across the board by 10%an amount that would be largely unnoticeable in many contextswe could reduce overall mortality rates by up to 1.26%. For mass public health, reducing alcohol in alcoholic beverages could make the biggest immediate impact simply because people would drink less ethanol for the same volume of beverage. Similar research on tobacco has even demonstrated that, by swapping cigarettes for lower nicotine cigarettes for six weeks (in randomized double blind trials), people reduced their dependence on and craving for nicotine. Simply offering less of a drug seems to be a good way to get people to consume less of it: even making cups smaller can lead people to drink less at parties. As for individuals, drinking can be a tough habit to break without breaking up with your rituals and social circles associated with it. But if you want to make abstinence feel easier, one of the most effective things you can do is to make more plans for the morning. People who had activities like exercising or volunteering planned for the next day are about half as likely to drink the night before. My biggest takeaway from a couple decades of enjoying alcohol is that, deep down, Ive always known it wasnt good for meeven when studies conveniently teased that a glass or two of wine a day might lengthen your life. Reaching into the fridge for an NA beer feels sneakily similar. You can never have your cake and eat it too. Something always costs something. But I also recognize my concerns are probably vastly overblown, and in just a few years, culture is attempting to reframe and reconcile thousands of years of practices weve had around alcohol. Perhaps not every decision we make is perfect (and thank god or what fun would life be?)but when it comes to our physical health, theres almost always a better thing we can be drinking, and chances are, that glass of NA will do you more good than harm. Liana Reid, who kicked her own heroin addiction decades ago to become a professional interventionist, puts it all pretty bluntly. If were gonna save some lives, people can save some lives by switching to NA, she says. It won’t have the same effect. They won’t end up in another country or behind the wheel of a car killing somebody.
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Anne Frank’s checkered diary is sitting on a desk. Trinkets are scattered on the shelf above itsome pencils, black-and-white photos, and a pair of metal scissors. Postcards and photos of 1920s celebrities like Greta Garbo and Norma Shearer are pasted on the yellowed wallpaper behind it. The room looks almost as though Anne was just there, picking photos to put up on the wall. But nothing actually happened here. Because here is in a room, in a museum, in Manhattan. And the room is not the secret annex where Anne spent two years in hidingit is an exact replica. Opening on International Holocaust Remembrance Day, Anne Frank the Exhibition was created by the Anne Frank House inside the Center for Jewish History. The exhibition offers the first opportunity outside of Amsterdam for visitors to see how Anne, her family, and four other Jewish people lived in an 800-square foot space, in hiding from the Nazis. [Photo: John Halpern] Anyone who has visited the Anne Frank House museum in Amsterdam knows that the original secret annex is eerily empty. That’s by design. After the family was arrested, the apartment was pillaged by the Nazis and left bare. Anne’s father, Otto, who was the only survivor among the people who lived there, wanted to keep it that way to symbolize the emptiness he felt when he returned from the Auschwitz concentration camp. By comparison, the New York annex looks lived in. Visitors are getting a completely different experience, says Tom Brink, the head of collections and presentations at the Anne Frank House in Amsterdam, and the exhibitions curator. The New York annex portrays Anne less as a victim and more as a young girl who liked collecting postcards and dreamed of becoming a journalist. A young girl whose life was cut short by the Holocaust. Anne Franks poetry book [Photo: Ray van der Bas] From Amsterdam to New York At the Manhattan museum, the story of Anne Frank feels both timely and suspended in time thanks to the exhibition design, which splits the show into two parts. There’s the exhibition, which begins in the 1920s and ends in the present day with 79 editions of Anne Franks The Diary of a Young Girl displayed in different languages. Then there is the replica of the secret annex, which appears somewhere in the middle (both physically and temporally), from behind a giant bookcase. Designer Eric Goossens was responsible for the exhibition, while set designers Annemiek Swinkels and Willem Claassena couple based in Amsterdamfocused on the replica of the secret annex. [Photo: John Halpern] The Frank family had ties to New York, which is why the Anne Frank House chose New York City as the first location for this exhibition. (Otto worked as an intern in the Macy’s department store, then tried emigrating to the U.S. before going into hiding.) But Ronald Leopold, executive director of the Anne Frank House, says the team is not excluding the possibility of a traveling exhibition, so the set designers had to build the show like a kit of parts that could be assembled and reassembledlike a Lego set, Swinkels says. The set designers spent months building the annex in the Netherlands, then sent it across the Atlantic in one giant shipping container. [We] used lots and lots of security straps, says Swinkels, noting that when the set finally arrived in New York, the team spent three weeks dressing it with various artifacts and furniture. The Anne Frank Foundation wanted it to look like the people in hiding were living there, and that’s hard if you don’t go for details, she says. The annex looks artificial and authentic at oncealmost like a life-size doll house where eight people played house for two years until the real world caught up to them. But visitors who can move past this dissonance will be rewarded with a poignant story that was made all the richer by the designers’ painstaking re-creation, which includes peeling wallpaper, and pencil marks chronicling Anne’s and her sister Margot’s heights. [Photo: John Halpern] Turning a set into a lived-in house Swinkels and Claassen are no strangers to Anne Frank’s life. In 2020, they built the set for a local TV show called Anne Frank Video Diary. They pored over Anne’s diary looking for details about layout and furnishings. They spent one whole night measuring and documenting every inch of the actual annex in Amsterdam. They scoured antique shops and local secondhand markets for replica furniture that matched the aesthetic of the annex, like wooden light switches, old light bulbs, and a Delft-tile ceramic toilet. They also referenced a scale model Otto had built in 1961 that hinted at the decor and furniture layout inside the annex, as well as a VR tour that the Anne Frank House launched in 2018. By the time they were invited to design the New York replica, the designers had amassed a wealth of knowledge, but because they had broken down the set after the TV series wrapped, they had to source new pieces from scratch. Otto Franks chair [Photo: Ray van der Bas] The designers met various people from all over the Netherlands to source the furniture. Anne’s replica desk, for example, came from an 85-year-old Dutch gentleman who was just 5 when Allied soldiers drove through his street. He felt really proud when he saw the table in the set, Swinkels recalls. Otto’s replica bed came from an elderly woman named Jutta; it had belonged to her grandparents who lived in Germany. We tried our best to collect real antique props and not copies, says Swinkels. But what mattered more wasn’t buying the exact chair, or getting right the exact corner on which Otto would’ve left his spectacles. It was getting Anne’s story right. In the kitchen, visitors will notice two objects. One is a board game about the stock market. The other is a partly darned sock tangled in sewing tape. The board game is the same one that Anne and Peter van Pels (Anne’s boyfriend and one of the seven people she lived with) played while in hiding. The sock is imaginary. But both objects paint the portrait of a family trying to live a normal lifein horrendously abnormal circumstances. Past and present collide The exhibition focuses on the past, but it is also about the present. This story tells us something about who we are, who we can be, and who we want to be as human beings, says Leopold. Indeed, the show opens just days after billionaire Elon Musk, celebrating Donald Trump’s inauguration as the 47th president of the United States, threw his arm out into what many interpreted as a Nazi salute. It comes at a time when far-right extremism is rising all over the world. A time when antisemitism is skyrocketing alongside hate crimes against muslims, Asian Americans, and the LGBTQ+ community, most recently reeling from Trump’s executive order stating that there are only two genders. The exhibition is a reminder to stand against discrimination and prejudice, whether its in Israel or Gaza, Sudan or Ukraine, the U.S. or Mexico. Its a beacon of remembrance, says Leopold. Of the past. But of the present, too.
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