What if the key to improving America’s health isn’t just medical—but cultural, ecological, and deeply human? Join an extraordinary group of thinkers and practitioners—Colin Woodard, Nico Pronk, Ross Arena, and Robin Blackstone—as they connect the dots between regional culture, public policy, and individual care to reimagine how health actually works in the United States. From uncovering how centuries-old cultural divides shape today’s outcomes, to mapping health as a complex adaptive system, to introducing a bold new “Trajectory Engineering” framework that could transform care at both the bedside and the population level—this conversation will challenge assumptions and offer a compelling vision for change. The ideas are ready. The question is: who will help build what comes next?

Component presentations:

The Regional Geography of Health and Well-Being in the United States – Colin Woodard, MA, FRGS, Salve Regina University

Regional cultural characteristics dating back to the colonial era profoundly influence population-level health outcomes today. Woodard shares the team’s ongoing research revealing the cultural and political determinants of health, with individualistic cultures having generally poorer outcomes and lifespans than communitarian ones, which are more comfortable investing in public goods. Considering public health in the context of regional cultures and shifting how we approach interventions, at both the policy and clinical level, can improve health outcomes.  

The Ecological Framework for Population Health & Well-Being - Nico Pronk, PhD, MA, FACSM, FAWHP; HealthPartners Institute. Ross Arena, PhD, FAHA, FAACVPR; University of Illinois Chicago

Determinants of population health are based on multiple levels and scales ranging from cognitive (e.g., culture) and embodied (e.g., policy) to population (e.g., cognitive) and individual (e.g., norms and values). We map health across multiple levels: individual, interpersonal, organizational, community, regional, and national. This segment describes the creation of the ecological framework and the context in which it is applied, namely as a complex adaptive system. 

Trajectory Engineering: Bending the Arc of American Health - Robin Blackstone, MD, FACS; Blackstone Health.

Trajectory Engineering is a published framework (SSRN, 2026) for observing, modeling, and bending the trajectory of health and disease at the resolution of the individual and the scale of the population. Drawing on the architecture detailed in Doctor AI: Reimagining Healthcare, Rebuilding Trust, Delivering Health 4.0, Blackstone presents a Triangle of Trust — patient, clinician, and Doctor AI — that turns the cultural and ecological determinants Woodard, Pronk, and Arena describe into a clinical instrument the bedside, the clinic, and the health system can actually operate. The architecture is published; the question now is how, and with whom, we build it.

 Presenter Biographies:

Colin Woodard, MA, FRGS, is the director of Nationhood Lab at Salve Regina University’s Pell Center for International Relations and Public Policy. A scholar of U.S. regionalism and nationhood, he is the author of seven books including American Nations: A History of the Eleven Rival Regional Cultures of North America, Union: The Struggle to Forge the Story of United States Nationhood, and Nations Apart: How Clashing Regional Cultures Shattered America. A George Polk Award recipient and Pulitzer Prize finalist, he is a graduate of Tufts University, and the University of Chicago, a Visiting Scholar at the HealthPartners Institute in Minneapolis and a Fellow of the Royal Geographical Society in London.

Ross Arena, PhD, FAHA, FAACVPR is a Professor at University of Illinois Chicago, Visiting Scholar at HealthPartners Institute, and Member of the Roundtable on Obesity Solutions at the National Academies of Sciences, Engineering, and Medicine. He received his Ph.D. in Physiology in 2001 from the Medical College of Virginia/Virginia Commonwealth University.  Dr. Arena has been instrumental in the successful implementation of several innovative healthy living initiatives in the academic, clinical and community settings and founded the Healthy Living for Pandemic Event Protection (HL-PIVOT) network in 2020.  Dr. Arena’s scholarly interests include: 1) The exploration of ecological drivers of health; 2) Healthy living initiatives that promote the healthspan; and 3) Exercise testing and training in patient populations.  Dr. Arena has published extensively in these areas with over 1100 peer-reviewed publications, abstracts, and book chapters. 

Nico Pronk, PhD, MA, FACSM, FAWHP, hails from The Netherlands and is trained in exercise physiology and behavioral medicine. He is the president of the HealthPartners Institute, a large research and medical education institute in the upper Midwest, and Chief Science Officer at HealthPartners, Inc., a non-profit, member-governed integrated health system headquartered in Minneapolis, Minnesota. He also serves on the affiliated faculty as professor of health policy and management at the University of Minnesota, School of Public Health. Nico’s focus is on the translation of evidence of effectiveness into decision-grade evidence to measurably improve population health at scale. He served as co-chair of the Healthy People 2030 initiative setting the health goals of the nation for the year 2030. Along with his collaborators, Nico designed the Ecological Framework of Population and Well-Being, a model that has been used successfully to show the importance of forcing factors, including cultural geographies, on a variety of population health outcomes.

Robin L.P. Blackstone, MD, FACS, is a metabolic and bariatric surgeon, chronic disease specialist, founder of Blackstone Health, and author of Doctor AI: Reimagining Healthcare, Rebuilding Trust, Delivering Health 4.0 (April 2026) and American Health — Who Gets Paid (January, 2026). She is the originator of Trajectory Engineering, a published framework (SSRN, 2026) for observing, modeling, and bending the trajectory of health and disease at the resolution of the individual and the scale of the population. The first woman President of the American Society for Metabolic and Bariatric Surgery, she led the national implementation of the MBSAQIP Quality System and held the Ira A. Fulton Endowed Chair in Metabolic and Bariatric Surgery at Banner Health, where she also served as Medical Director for Surgery at University Hospital (2015–2021) and helped found the "Obesity Week" curriculum at the University of Arizona College of Medicine – Phoenix in 2007. She later served as SVP and Global Medical Director at Ethicon, a Johnson & Johnson company. She writes in New York and photographs health and culture around the world.