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Military

Serving Our Veterans: Public vs Private (Part 2 of 4)

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Part one of this series analyzed the history of the Bonus Expeditionary Force (BEF) and their actions during the Great Depression, and how its influence dramatically affected how the US government treated its brave men and women that go to war. In this second installment, I will take a  look at a key tension that has persisted from the days of the BEF up until our modern era. It is important to consider the historical context of these tensions when attempting to understand how we serve our nations military veterans.

Public vs Private

Public vs Private

The Public vs Private tension continues to work its way into social welfare discourse in the 21st century, but during the 1930’s it was just as rampant. In regard to social work, public represents services administered by a public agency, while private represents services provided through private charities, individuals, and groups. Previous to the Great Depression, by and large the aid and relief services were provided by private charities and local governments. Once the Great Depression hit, these private agencies were stressed to serve the needs of the millions who were suffering and starving; many of the available services at the time could not even shelter the homeless or feed the hungry.

Before the 1930’s and the Great Depression, issues like poverty and unemployment were primarily viewed as problems with the individual, rather than problems with the environment that individual lived within. Through that perspective, the common approach of the time was to address individual problems through private charity. With millions beginning to suffer from the Great Depression, the perception of social welfare began to shift. More people started to see that issues surrounding poverty had to be elevated to a public issue rather than maintain the narrow scope of a private or individual issue.

During this paradigm shift, it became evident to social workers and policy makers that the rising needs brought on by the Great Depression could only be addressed by public agencies . “Voluntary charity simply could not cope with the situation; only public agencies could deal with the collapse of the economy, mass unemployment, and widespread destitution”(Trattner, 1999) . As a result of this change in perspective, we created the U.S. Social Security Act of 1935, among several other programs. Public assistance worked its way into social policy and between 1929-1940 the number of persons on assistance or work- relief programs rose from less than a million to 9 million.

This tension between Public vs Private assistance took time to play out, and it had a direct impact on the wait time that veterans in the 1930’s seeking their Bonus had to endure. This was due to the observable conflict among political powers during the Bonus March era. President Hoover was adamant that assistance to the needy had no place for the public sector for a variety of reasons: “[f]or him, relief was a moral, not merely an economic, matter; private charity (such as he had distributed in war-ravaged Europe) was fine, but public aid, especially from national government, was a ‘dole’” (Trattner, 1999). As a result of these conflicts, it created several barriers to passing legislation that supported public assistance.

Subsequently, although the Great Depression proved that public agencies were the only group capable of providing adequate aid to those in need, tension existed and continues to this day. Unfortunately, the veterans of the Bonus Expeditionary Force just happened to be caught in the middle of all of it. Present day, those who are in need of services, including veterans, get caught in tension between the power sources who advocate for Public vs Private assistance.

In the next two parts of this series, I will be analyzing Micro vs. Macro and the long term implications of these paradigm shifts. Please stay tuned.

References:

Fisher, J. (1980). Social Work: The thirties as a watershed. In J. Fisher, The response of social work to the Depression (pp. 233-241). Boston, MA: G.K. Hall & Co.

Gordon, L. (1992). Social insurance and public assistance: The influence of gender in welfare thought in the United States, 1890-1935. American Historical Review 97, 19-54.

Trattner, W.I. (1999). Depression and a New Deal. In W. I. Trattner, From poor law to welfare state: A history of social welfare in America (6th ed.) (pp. 273-303). New York: Free Press.

Chris is pursuing a Masters in Social Work through the University of Washington's part time, extended degree program.

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Mental Health

Will Veteran Suicide and Mental Illness Rate Improve?

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Even in Afghanistan, I will seek pet therapy! – Rick Rogers (pictured above)

It was about 9 years ago.  I decided to put down the rifle and pick up the DSM. You see, I was an infantryman since I was age 17.  That means, since I was a child, I was literally trained to kill people.  Looking back at it, that sounds like a profound concept.

I am proud of my time in the military.  I am proud of my brothers and sisters who have ever answered the call.  But…  I am also worried.

As I said, 9 years ago, I decided to change my path.  I didn’t realize where that path would lead.  I seen multiple traumas and death happen to my fellow comrades.  I went through some trauma myself, but I still worried about others more than myself.  So, I decided to become a Mental Health Specialist in the military.

It’s been a long road going from Infantryman to Social Worker. There are a lot of learned attitudes and behaviors I had to change. Can you believe it? I literally had to learn empathy.  And that took a long time.

Just about anyone in the military knows that drinking alcohol is a part of the lifestyle. Everyone I looked up to drank and considered me a p**sy if I didn’t.  So… when I was sent to Germany back in the early 2000’s as a 19 year old kid, you better believe I drank. It was legal!

Looking back at my adventures between then and now, I don’t regret a thing. Yes, there were many embarrassing moments, and I have lost many friends along the way.  I also met some great people.  My alcohol use made my path rockier than anything else.

Many others have had this experience as well.  Between 1998 and 2008, binge drinking went from 35% to 47% of veterans, and 27% of that 47% experienced combat. 

Between 2002 and 2008, misuse of opiate prescriptions went from 2 percent to 11 percent in the military.  These prescriptions were mostly due to injuries sustained in combat, as well as the strain of carrying heavy equipment.

This concerns me. When I was young, I had a good time. Looking back, maybe it wasn’t.This might not be every veteran’s experience, but the culture encouraged substance use and discouraged getting help. There are others that would agree with me.

This could explain why 20 veterans a day on average commit suicide. This is actually down from 22 a day before the 2014 study from the VA.  However, it is a 32% increase since 2001. In 2014, veteran suicides accounted for 8.5% of U.S.’s adult suicides, and the rates were especially high among 19-29 year old compared to the older generation.

Let’s not forget about the infamy of PTSD. Up to twenty percent of veterans have suffered from this. Of course, those who suffer are more likely to admit their distress to a computer program than a battle buddy or their superior.  This, again, goes with the constant culture that causes our military to fear judgment.

These wars have been a constant the last two decades, and have cost all U.S. citizens a pretty penny. According to one report, the VA spends $59 billion a year on health care.  This number is 3 times as much as it was since before 2002.

And let’s not forget the cost this country has incurred for being in war for this long.  Well, we don’t really know an exact number.  The cost is estimated by many to be in the billions or even trillions.  This isn’t including the interest from borrowed money.

So, after looking at all these figures, I am overwhelmed.  How can I even make a dent in helping our nation’s veterans? The current administration is planning on increasing our presence in war zones.  I am expecting the rate of PTSD and suicide to increase once again.  Also, our country will continue to spend.  It seems to me that we are all participating in a death and mental illness factory.   The thing is, I didn’t even get to the physical injuries many of our combatants have suffered from.

I love our nation’s military.  I want every one of them to know that I am here to support them.  But most of all, we all need to be here to support each other.

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Mental Health

UA Study to Take ‘Deep Dive’ into Risk Factors for Veterans, Suicides

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University of Alabama researchers, America’s Warrior Partnership and The Bristol-Myers Squibb Foundation have partnered on a four-year, $2.9 million study to explore risk factors that contribute to suicides, early mortality and self-harm among military veterans.

“Operation Deep Dive,” funded by the Bristol-Myers Squibb Foundation, aims to create better understanding of the risk-factors, particularly at the organizational and community level.

Drs. Karl Hamner, director of the Office of Evaluation for the College of Education, and David L. Albright, Hill Crest Foundation Endowed Chair in Mental Health and associate professor in the School of Social Work, are the principal investigators for UA on the study.

Recent research has shown that neither PTSD nor combat exposure are good predictors of veterans and suicide, so researchers must cast a wider net, Hamner said.

“Previous research has focused primarily on individual-level risk factors, like prior suicide attempts, mood disorders, substance abuse and access to lethal means, but suicide is a complex phenomenon, and those factors don’t paint the whole picture,” Albright said.

The study is innovative in that it focuses on veterans across the spectrum of service, gender and lifespan, utilizing data from America’s Warrior Partnership and the U.S. Department of Veterans Affairs, new data collected during the study, and data from the Department of Defense.

For instance, female veterans, who are 2.5 times more likely to commit suicide than civilian women, will be spotlighted in the study.

Both the DOD and the VA will be vital in identifying veterans with varying medical histories, combat experiences and discharges from military services. America’s Warrior Partnership will also help fill the gaps in identifying veterans who don’t fit criteria for VA benefits, like National Guard or Reserve personnel who aren’t activated, or anyone who has a dishonorable discharge, which could be for a variety of reasons.

“The scope of this study is timely and so needed that we really believe we can move the needle,” Hamner said.

The first phase of the study is a five-year retrospective investigation of the DOD service use and pattern of VA care utilization to examine the impact of less-than-honorable discharges on suicides and suspected suicides, and the differences in suicides between those who receive and do not receive VA services.

“Helping to identify the trends or predictors of veterans’ suicide could help immensely in reducing suicide rates and provide much needed interventions for this community,” says John Damonti, president of the Bristol-Myers Squibb Foundation. “This project will take a deep dive to better understand what was happening at the community level to design better, more targeted intervention programs.”

The second phase will incorporate these findings into a three-year study that will include input from medical examiners, mental health experts, veterans and family members, and the community to conduct a “sociocultural autopsy” of all new or suspected suicides in America’s Warrior Partnership’s seven partnership communities, as well as in comparison communities.

The results will explore how community context and engagement affect prevention of suicides in veterans and “why some former service members commit suicide, while others do not.

“The overarching goal of the study is to understand triggers of suicide in order to prevent potential suicides before they occur,” said Jim Lorraine, president and CEO of America’s Warrior Partnership. “With each organization bringing its own areas of expertise and data, we can make a difference in the lives of our nation’s warriors, particularly the most vulnerable veterans.”

Both Hamner and Albright are committee chairs for the Alabama Veterans Network, or AlaVetNet, which connects Alabama veterans to resources and services. Alabama Gov. Kay Ivey recently signed Executive Order 712, which tasks the group in helping reduce and eliminate the opioid crisis as well as reducing the high veteran suicide rate.

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LGBTQ

Military Service Boosts Resilience, Well-Being Among Transgender Veterans

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Transgender people make up a small percentage of active-duty U.S. military personnel, but their experience in the service may yield long-term, positive effects on their mental health and quality of life.

A study from the University of Washington finds that among transgender older adults, those who had served in the military reported fewer symptoms of depression and greater mental health-related quality of life. The findings were published in a February special supplement of The Gerontologist.

The paper is part of a national, groundbreaking longitudinal study of LGBT older adults, known as “Aging with Pride: National Health, Aging, Sexuality/Gender Study,” which focuses on how a range of demographic factors, life events and medical conditions are associated with health and quality of life.

Estimated numbers of U.S. military personnel who are transgender vary widely, but range between one-tenth and three-quarters of 1 percent of the roughly 2 million active-duty and reserve forces. A study from UCLA estimates about 134,000 transgender veterans in the United States.

The new paper, by researchers from the UW School of Social Work, explores how military service affects transgender people because previous data indicated that, among LGBT people over age 50, those who identified as transgender were more likely to be veterans than lesbians, gay men or bisexuals.

Reports have indicated that transgender individuals serve in the military at higher rates than people in the general population. In the 2015 U.S. Transgender Survey of 28,000 individuals, 15 percent said they had served, compared to about 9 percent of the U.S. population overall. And yet, little is known about how military service influences the well-being of transgender veterans later in life.

Other studies have shown that transgender veterans suffer higher rates of depression than other veterans. UW researchers were somewhat surprised, then, to learn that the transgender veterans they surveyed tended to have better mental health than transgender people who hadn’t served, said lead author Charles Hoy-Ellis, a former UW doctoral student who is now an assistant professor at the University of Utah College of Social Work.

The traditionally masculine culture of the U.S. military would seem to be a potentially difficult environment for someone who doesn’t identify with the gender they were assigned at birth, he said.

But military service creates its own kind of identity, the authors said, because it presents often dangerous and traumatic challenges; overcoming those challenges builds resilience. And that’s where the identity as a transgender person enters the picture.

“Many people develop an identity as a military person — that it’s not just something they did but something that they are,” said Hoy-Ellis. “If transgender people, who are among the most marginalized, can successfully navigate a military career, with so many of the dynamics around gender in the general population and in the military, then that experience can contribute to a type of identity cohesiveness.”

The internalizing of negative stereotypes, such as those around sexual orientation, is considered a risk factor for poor mental health, added co-author Hyun-Jun Kim, a UW research scientist in the School of Social Work. Military service could be the opposite — a protective factor.

“Often when people think of the transgender population, they focus on the risk factors, but it’s equally important to focus on the protective factors and nourish those resources. In this case, what aspects of military service contribute to being a protective factor?” Kim said.

Researchers said they were somewhat limited by the size of their study sample: Out of the 2,450 people ages 50 to 100 who were surveyed for Aging with Pride, 183 identified as transgender. Of those nearly one-fourth, or 43, had served in the military. Of those who had served, 57 percent identified as female. People of color made up 29 percent of the transgender veterans in the study.

But as awareness grows about gender-identity issues, there is an opportunity to address support services for transgender veterans at the federal level and in the community, Hoy-Ellis said.

“This is a population that has served the country very proudly, and it’s important that we recognize that service,” he said. “Learning what we can about transgender older adults with military service may help us develop and implement policies and programs for people who are serving today.”

Other co-authors were Chengshi Shiu, Kathleen Sullivan, Allison Sturges and Karen Fredriksen-Goldsen, all in the UW School of Social Work. Funding was provided by the National Institutes of Health’s National Institute on Aging.

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Education

More Veterans Have Enrolled in College with Post-9/11 G.I. Bill

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Capt. Irvin Drummond, U.S. Army, studies at a computer 18 May 2007. (Photo by Chris Sanders, U.S. Army)

The Post-9/11 G.I. Bill, which covers educational costs for veterans beyond tuition, has boosted college enrollment rates among veterans by 3 percentage points compared with the earlier G.I. Bill, finds a new study by NYU’s Steinhardt School of Culture, Education, and Human Development. However, the increase in enrollment was much larger immediately after the bill’s adoption and has waned in recent years.

The study, published online in the journal Educational Evaluation and Policy Analysis, a journal of the American Educational Research Association, comes days after Congress passed a major expansion to the G.I. Bill, which – if signed into law – will provide additional educational benefits to veterans.

The Servicemen’s Readjustment Act of 1944, commonly known as the G.I. Bill, helped pay for college and other training for millions of World War II veterans. Since its inception, the G.I. Bill has been updated to continue providing educational benefits, with the most recent expansion being the Post-9/11 Veterans Educational Assistance Act of 2008, or Post-9/11 G.I. Bill.

“The original G.I. Bill not only significantly improved the human capital in the United States after World War II, but also democratized American higher education and created a robust middle class. Education benefits provided by the bill allowed veterans to go back to college and obtain necessary knowledge and skills, while also serving as an important entry point back to civilian life,” said Liang Zhang, the study’s author and a professor of higher education at NYU Steinhardt.

The Post-9/11 G.I. Bill, which took effect in August 2009, offers more generous educational benefits than the previous version of the bill. It covers full tuition and fees at in-state public schools (or up to a set amount for tuition and fees at private institutions), a monthly housing allowance, and up to $1,000 a year for books and supplies. All veterans who have served since September 2001 are eligible for the Post-9/11 G.I. Bill, meaning that those who did not take advantage of benefits under the previous bill were retroactively eligible.

In this study, Zhang examined the impact of the Post-9/11 G.I. Bill – including its monthly housing allowance and stipend to cover miscellaneous educational costs – on veterans’ college participation.

Zhang used 11 years of data (2005 to 2015) from the American Community Survey, which resulted in a sample of approximately 200,000 veterans who have served in the post-9/11 era. This sample enabled a comparison between data from before and after the 2009 adoption of the Post-9/11 G.I. Bill in order to determine how veterans might have reacted differently to the bill over time.

Zhang found that the Post-9/11 G.I. Bill increased overall college enrollment by about 3 percentage points when compared with enrollment prior to the bill’s adoption. However, the effect was much larger immediately after the bill’s adoption (approximately 4 percentage points) and has waned in recent years (to about 2 percentage points), suggesting that part of the initial enrollment burst was due to the retroactive nature of the bill.

Despite the increase in enrollment, Zhang noted that the effect of the Post-9/11 G.I. Bill is much smaller than the effects of typical financial aid programs, which have been shown to improve enrollment by about 3 to 6 percentage points for every $1,000 reduction in college costs.

In addition, Zhang examined how the bill affected college enrollment among veterans ranging from 20 to 60 years old, given that veterans typically follow a different educational trajectory than that of nonveterans. He found that the Post-9/11 G.I. Bill has had a consistent and positive impact on college enrollment among veterans of all ages, even among older veterans who are usually considered less likely to enroll in college.

“This suggests that older veterans may be more responsive to financial incentives, echoing previous research findings that older students are more responsive to financial aid than younger students,” Zhang said.

Finally, Zhang looked at the levels of existing educational attainment among veterans, since the Post-9/11 G.I. Bill can be used for a variety of educational and training programs, including both undergraduate and graduate education. He found consistent and positive enrollment effects across veterans with all levels of education, with those already holding master’s degrees taking the most advantage of the bill’s educational benefits.

Zhang concluded that it is both important to evaluate the effect of veterans’ programs on college enrollment, as well as to consider the social impact of the bill – which is broader and more profound than any college-related outcomes could possibly measure.

“While providing generous education benefits to veterans could ease the financial burden of going to college, research shows that veterans can face additional challenges associated with service-related injuries and disabilities, as well as being older students. Higher education institutions must continue to better understand and support this growing, yet potentially vulnerable student population, to best serve those who served the country,” said Zhang.

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Military

What Do Service Women Need: Invisible Veterans but Resilient Leaders

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As a military health researcher, I hear veteran women tell me all the time that they sometimes feel invisible. The Service Women’s Action Network is calling for active duty, reserve, Guard, and veteran women to help change that.

Take our 2017 needs assessment and help government, community, and advocacy groups develop THE RIGHT programs to meet the needs of military women past, present, and future. The survey is short and easy, and it will help us make our community’s diverse voices heard.

Our assessment last year helped us understand and share information about belonging and support – it shed interesting light on the need for service organizations to open their doors to women in new, inclusive ways.

You see, women veterans share many of the exact same concerns of our male colleagues; yet we also face unique issues, especially when it comes to accessing services after we leave active duty.

Some of the most important places veterans connect, network, and socialize while transitioning are Military and Veteran Service Organizations (MSOs/VSOs). However, our team’s latest research in the Journal of Veterans Studies indicates that women veterans participate less and even report feeling unwelcome in those very spaces.

Be part of the solution this year by taking the survey! Military women are some of the most resilient leaders you’ll meet, and you can change our reintegration experiences if you help make that visible.

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Health

Loneliness Kills: Lessons From a Combat Hospital

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Kate Hendricks (center)

I used to think I understood health. I worked in fitness and told people about it for a living. I WAS WRONG. Focusing only on movement and nutrition, I was missing the bedrock concept upon which real health is built. We are wired to connect and social health is the foundation of human well-being. (Check out the science behind this in my just-released TEDx talk).

This is what I study today, but in a life quite different than my current as a suburban mom and public health professor, I was a Marine Corps Military Police Officer. I have a little brother who also joined the Marines and we’ve always been very close, probably because we had to be! When we were young we moved over 20 times – there was many a summer where my siblings were my only friends because we were the new kids.

I was already deployed to Iraq when he e-mailed me to share his grand romantic plans to propose to his girlfriend before he headed over. She was a civilian schoolteacher that I had yet to meet. I was in my cynical deployment mode and I was surrounded by Marines receiving what we call “Dear John” letters. They often read the same, “the grind of deployment is too much, our relationship is over, I already have a new significant other, the end.” I didn’t think his proposal would wind up any differently because he was headed to Iraq right behind me, but I wanted to be supportive so I told him I didn’t have a problem with the proposal but admonished him to buy her a ring made out of cubic zirconia. No sense in buying a diamond he might never get back.

As younger brothers often do, he ignored my advice and bought her a beautiful ring.

Well, that is some cash he will never see again! Should have listened to me!

When he was coming in I had convoyed south and I was able to be there at the hangar in the middle of the night when he flew in. Even armed and incredibly well-trained my brother will always look like a little kid to me. He was walking towards me with a huge pack on his back, a Kevlar on his head, and a rifle in his hands. All I could see were his big, blue eyes peeking out like a turtle under all that gear and I thought, “who let a ten year old on the plane with a rifle???”

As I stood watching his C-130 unload on the tarmac I forgot to feel invincible for a moment and my heart sunk – I knew where he was heading and I knew what was happening there. I had some big sister notions of telling him what he needed to know to stay safe during his deployment and for the first time it occurred to me that may not be enough.

Soon after I was headed home to the states and I didn’t know it at the time, but he was as well. Except that an improvised explosive device made sure that his trip home was wounded and on a stretcher.

When a service member is medically evacuated and they make it to the stateside hospital, there are no guarantees and a lot of unknowns.

When my brother arrived at Bethesda, we didn’t know what he might be facing. Our family came together to be there for him, but even with our support system gathered, Bethesda was a dark place some days.

Into this world walked my brother’s civilian schoolteacher.

Frankly, I didn’t yet know if she was part of our close-knit family. I had stereotyped her on sight—mostly because she was a pretty girl who often wore makeup and always had on matching accessories. I was waiting for her to fall apart.

She never did.

When her leave ran out at work she went back to teaching all day long in nearby Virginia, but made the drive every night to sleep in a chair at my brother’s bedside. I was terrible in that hospital room always dropping things – just graceless. She kept him smiling and focusing on their future together. She kept him connected to their community of friends when he left the hospital and had to spend his days in a reclining chair. She kept him looking forward to new plans to build a family, even when they had to install bars over his bed at home and he needed help with the most basic tasks.

That makeup had fooled me; she was more than serious. She showed up, and she was a foundation for my little brother when he really needed one.

They got married and she gained three sisters that would help her hide a body today if she asked.

She has a really good memory though. Every now and again, I hear about that cubic zirconia comment.

The Science of Social Cohesion

Here’s the truth about human health – nothing will kill you faster than loneliness.

We know all of this because scientists have studied social cohesion from a variety of angles and proven that disconnection is dangerous! We’ve studied partner relationships, friendships, civic involvement – it is all important and comprises our social health. In one study, medical students without many friends had depressed immune systems. A 30 year study out of Roseto, PA found that support protected against heart disease even when diet wasn’t ideal. My own research has demonstrated convincingly that people without partnerships are at greater risk for depression.

We talk in public health about behaviors that offer something called protective effect and upping your social support has more protective effect than quitting smoking. Don’t hear me wrong – smoking is still bad!

The reason for that can be found in our physiology. Stress hormones surge when you’re feeling lonely or rejected, and if this happens too often or for too long, you start seeing problems.

Cortisol and adrenaline are useful when facing a real threat – they fire us up to respond, but they also shut down everything non-essential. Our heart rate and our breathing rate jump up and blood flows to our biggest muscles. Energy to the logical brain, digestive system, even blood flow to our extremities is diverted.

If hormone levels stay up, you can imagine the problems your body starts to face. At first, diminished blood flow to the extremities is just cold fingers and toes. Over time it might become neuropathy. Then, you stop feeling and have trouble picking things up or even balancing – in this way our body is trying to signal us – loudly, in the only way that it can – social numbing becomes physical numbing.

Our brain activity being interrupted may mean initially only that it becomes tough to find our car keys. Soon enough, we begin to have difficulty communicating, displaying empathy, or engaging in high-level thinking. This makes connecting with others even more challenging, and our isolation can easily become self-perpetuating.

I work in military public health today, and for a long time all we talked was the correlation between post-traumatic stress and combat deployments. That’s not the whole story, though – it’s far too simple. The riskiest time for veterans is that first six months coming out into the civilian world. We face that complex mix of losing identity, our purposeful, all-consuming work, and the biggest loss – our tightly-bound community.

Conclusion: So-What Factor

When social support is happening the way we want it to, you get a veteran reintegration story like my brother’s.  In our family, he is still everyone’s favorite. He’s now a dad and a slightly-intense High School English teacher.  His wife is hilarious and keeps us all on our toes.

When it’s not, you get one like mine and like too many of our service members leaving active duty today.

I struggled with pulling the right people around me after a deployment and that time at the hospital. I was angry, guilty, then angry some more. I drew inward and sought to surround myself with people who had similar experiences to my own.

The results for me weren’t pretty. I worked too hard, drank too much, communicated not at all. I found a relationship that was as volatile and crazy as I was feeling on the inside. I didn’t know the meaning of the word “introspection” or the phrase – ‘I need help.’” There was a time I could’ve wound up an isolated, angry statistic.

The social health issues I’m talking about aren’t strictly veteran problems. The angry veteran, the elderly shut-in, the person in an emotionally abusive relationship all deal with the same physical effects.

All of us have to prioritize it.

I was never lonely exactly, I certainly had people around me, but I had too many of the wrong people, and I had no one who ever challenged the way I was doing things.

We all need the strength that an uplifting group of different – and thus complementary – personalities bring us. So I had to ask myself, as I encourage you to ask yourself – how are my people?

Do they support you? We need affirming, yes.

Do they challenge you? We also need different.

Connect. Be willing to get a little uncomfortable – It can completely change your health.

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