Enrique Caballero and Misty Anaya - Diabetes Awareness Month!

>> HINOJOSA: 16 million

Americans have been diagnosed

with Type 2 diabetes, and many

more are unaware they're at high

risk.

A large and growing percentage

of them are teenagers.

What do we need to know about

this epidemic?

Meet Dr. Enrique Caballero from

the Joslin Diabetes Center and

Misty Anaya, diagnosed at age

12.

I'm Maria Hinojosa, this is One

On One.

Dr. Enrique Caballero, welcome

to our program.

>> CABALLERO: Thank you, Maria.

>> HINOJOSA: You are the

director of the Latino Diabetes

Initiative at Joslin Diabetes

Center in Boston.

Essentially, you have dedicated

your entire life to the issue of

diabetes.

And there are probably a lot of

people who say, "Oh, I know that

there's diabetes; I know

somebody who has diabetes; I

know that in some people it can

be really dangerous, in other

people, they can manage it."

So I'm a little confused.

So what is the headline?

What do we need to know about

diabetes that is central to the

issue?

>> CABALLERO: Well, the first thing, Maria,

is that diabetes is a major

health care problem around the

world.

This is not just in this

country, it is everywhere.

>> HINOJOSA: But it's not

something that you see, right?

Isn't that one of the problems?

I mean, you can be living with

diabetes and be fine.

>> CABALLERO: Mm-hmm.

Actually, it is estimated that

perhaps, for Type 2 diabetes,

which is the most common type of

the disease-- ten times more

frequent than Type 1 diabetes,

for instance-- people only have

the disease for ten or 15 years

without knowing that they have

the condition until they

manifest the first symptoms,

which would be perhaps, like,

frequent urination, increased

thirst, fatigue, tiredness,

infections that don't heal or

don't get better very quickly.

But there's a silent face.

People may have the disease for

years and years without really

having any idea about the

presence of the problem.

And sometimes they know about

the disease because they have

already developed the

complications of the disease.

>> HINOJOSA: So if... if, for

example, you start having some

of these symptoms, are you

saying that people just won't go

to the doctor to deal with these

symptoms, or they might go to

the doctor but the doctor might

not test them?

Do you have to say, "Look, be

sure that you test me for

diabetes."

Is that what... or are we on the

assumption that doctors will

know to do this?

>> CABALLERO: Well, it is part of a routine

exam nowadays to check the blood

sugar.

It's a blood test, and it's part

of the annual physical exam, for

instance, for most people.

>> HINOJOSA: So key here--

annual physical exam.

>> CABALLERO: Yes.

>> HINOJOSA: That's something

that you want people to just

understand, that everybody

really needs to be getting an

annual physical.

>> CABALLERO: Absolutely, and this is not

just to check for blood sugar,

diabetes, it's also for the

blood pressure, for cholesterol,

to check the weight, for

instance, all these different

conditions that we don't really

pay a lot of attention to

because we feel well.

We don't realize that there's

something going on, because we

feel perfectly well.

>> HINOJOSA: All right, well,

let me... let's, though, get

back to the issue between Type 1

and Type 2 diabetes.

>> CABALLERO: Yeah, all right.

So let's start from the very

beginning.

Diabetes is a disease that is

characterized by high sugar

concentration in the blood that

we call glucose.

Now, there's different ways to

get to that high blood sugar.

In Type 1 diabetes, the problem

is that the pancreas, which we

have in the abdomen, does not

produce enough insulin from the

very beginning, and therefore,

people need to take insulin

injections.

This is most common in children

and adolescents, although

nowadays, anyone with... can

have Type 1 diabetes at any age.

>> HINOJOSA: So you're born with

it?

>> CABALLERO: You're not born with it, but

you have the genetic tendency to

develop Type 1 diabetes.

>> HINOJOSA: Okay.

>> CABALLERO: Now, most of these people are

thin, they do not have family

history of diabetes-- that's

sort of the norm-- and they, as

I said before, need insulin from

the very beginning.

Now, Type 2 diabetes, given that

it's also diabetes, is

different.

The pancreas may still be able

to produce some insulin,

particularly in the early stages

of the disease.

Another problem with Type 2

diabetes is that the insulin

that the body produces doesn't

work very well.

That's what we call "insulin

resistance," meaning the body

doesn't respond too well to

insulin action so the blood

sugars go up in the circulation

and then people may be able to

develop some complications.

Type 2 diabetes is more common

as we get older...

>> HINOJOSA: But...

>> CABALLERO: ...but one of the major

problems, Maria, is that now

we're seeing Type 2 in children

and adolescents.

>> HINOJOSA: That's what I was

going to say.

So now what we're hearing is

Type 2 diabetes, we're seeing it

in kids.

So what is happening with the

fact that we're now seeing Type

2 diabetes, which we associated

more with people kind of later

in life...

>> CABALLERO: Right.

>> HINOJOSA: ...what's happening

that now kids are getting it?

>> CABALLERO: So in an easy way, what I

always talk about is Type 2

diabetes-- let's remember the

number two, you know, Type 2--

has two problems.

One is that the pancreas doesn't

produce enough insulin, and that

the insulin that the body

produces doesn't work well.

Now, for both conditions,

there's two sources of problems.

One is a genetic predisposition,

which means that there is a

tendency to develop the disease,

because that comes from our

history, from our family

background, but it's also,

Maria, related to our lifestyle.

That's the other element that

plays a major role in Type 2

diabetes.

>> HINOJOSA: So we're talking...

>> CABALLERO: As we become overweight, we

don't exercise, we don't eat the

way we should, all those factors

contribute to that genetic

tendency then to develop this

very serious condition.

>> HINOJOSA: And you are the

director of the Latino

Initiative...

>> CABALLERO: Yes.

>> HINOJOSA: ...which means that

within the Latino community,

specifically, and in broader

senses, the African American

community, the Native American

community...

>> CABALLERO: Yes.

>> HINOJOSA: ...we are seeing

numbers that are spiking.

>> CABALLERO: Yes, more than in other

populations, and the reason for

that is the two elements that I

just mentioned.

The genetic predisposition and

also the lifestyle issues that

contribute to Type 2 diabetes

are more common in some of these

racial and ethnic minorities.

>> HINOJOSA: So for example,

paint a picture of when you are

in a barrio Latino and you're

just looking around, what is the

picture that you see that is

kind of raising flags for you?

>> CABALLERO: In some of these

neighborhoods where there's more

racial and ethnic minorities,

it's been well documented

there's less access to healthy

foods.

It's part of a cost issue-- it's

a financial situation-- but it's

also a social issue.

That sometimes, some of these

markets are more appealing to

some of these different groups

and also for businesses.

You know, they know that they

can actually succeed more by

providing some of these fast

foods, et cetera, in some of

these neighborhoods.

So it's really a big, big

challenge.

>> HINOJOSA: And the fast food

issue for communities of color

comes in because you have, let's

say, working parents?

Both of them might be working,

and so then the easy thing to do

is, "I'll just go by and pick up

those hamburgers or that fried

chicken or whatever," because...

not because you're a bad parent,

but because you've got a lot on

your plate and you're thinking,

you know, time, and you're

thinking money?

>> CABALLERO: Oh, well, it's an easy thing.

I mean, if you want to eat, you

know, fast food is really

available, it's affordable, it's

tasty, it's filling.

So it really has a lot of

advantages for the working

families, for people that don't

have a lot of time to prepare

the foods, et cetera.

So we have moved away somehow

from our traditions, also,

Maria, in the sense that...

>> HINOJOSA: Well, that's what I

was going to bring up.

>> CABALLERO: ...we used to cook at home,

and you know, that was sort of

the natural thing to do.

But now we're so busy, we have

to do a lot of different things,

and fast food has come to our

lives to sort of "solve" some of

the challenges that we have.

Of course, we are paying a huge

price for that type of decision.

>> HINOJOSA: Isn't it true,

also, that for newer immigrants,

when you come to this country

and you have a little bit of

extra money, then going to a

fast food place is like... it's

a step up.

>> CABALLERO: You're right.

>> HINOJOSA: Is there that kind

of situation where you have

immigrant parents who are like,

"Well, this is what people eat

in the United States of America,

and my child is an American.

I'm going to feed them fast

food."

>> CABELLERO: Right.

There is what is called

"acculturation," and

acculturation is related to the

adoption of the lifestyle in any

country that we go to if we live

there.

And it's been well documented

that, for people in the first

five years when they come to

this country, they tend to adopt

some of these lifestyle issues.

So as you said, people tend to

eat fast foods, they become more

sedentary as well, because

people may be able to buy a car

now.

So they don't exercise, they

don't walk, they don't ride

their bikes anymore, and people

tend to gain some weight.

If you think about it, the

immigrants are usually healthy,

young people that come and work

in this country, but in the

first five years their health

status usually changes.

They become more overweight,

they have more risk for

diabetes, high blood pressure,

high cholesterol, and after five

years, their risk of diseases is

a lot higher than what it was

when they were in their country.

>> HINOJOSA: This is just... I

mean, you're from Mexico.

Is there a part of you that just

wishes that you could just kind

of stand there with a big sign

that says, "If you go into the

United States, beware, because

what you're going to eat in the

United States and the lifestyle

you are now going to engage in

could make you sicker."

>> CABALLERO: It is true.

That's sort of the norm.

Now, at the same time, because

let's be fair, you also have

choices, because you can always

make good decisions.

You may decide to exercise, you

may decide to go for foods that

are healthier, and this concept

that always the... the better

foods are more expensive, you

know, is not absolutely true all

the time.

One of the things that we do in

our program, for instance, is to

teach people that within a

limited budget, you can always

make better choices, and you can

always-- even if you don't have

a lot of money-- go for better

foods, for those that have less

saturated fat, trans fats, you

know, healthier meals in

general.

>> HINOJOSA: But do you feel

that you are... you know, when

you look at our communities, our

immigrant communities, our

communities of color where there

is such a bombardment of, you

know, again, fast food,

not-such-healthy food, easily

accessible, and here you are

trying to say, "Wait, don't make

that decision; don't buy that

fast food; think about taking

the 45 minutes for cooking a

meal for your family," really in

the end, you have a huge battle

that you're confronting.

>> CABALLERO: Oh, it's a big battle.

It's a huge battle, Maria,

because there's so many messages

that are delivered every second

to the population about not

eating the right things, not

exercising, because we're

concentrating on other things.

>> HINOJOSA: I talk about it

with my kids all the time.

>> CABALLERO: Our values, you know, are

gone, and we have to rescue

those.

We have to go back to very basic

principles about living in

family, doing things together,

being more physically active.

We don't need a lot of the

outside messages and values that

the society wants us to acquire,

and if we go back to some of

those simple ways of living, we

could have healthier and better

lives.

>> HINOJOSA: So the conversation

about diabetes, and

particularly, Type 2 diabetes,

is one that is of concern to a

lot of people.

Even PBS-- Public Television--

has started talking specifically

to young people to hear their

stories and to kind of get their

stories out.

So we're going to take a listen

to one particular story.

Let's take a listen.

>> ANAYA I would say that I am

intelligent, funny, I would say

that I am very determined.

I am artistic.

I'm a hopeless romantic.

I'm an independent person, and I

have Type 2 diabetes.

"I told her the news and she

said, 'I'm sorry.'

This serious look was on her

face.

I said, 'Don't worry, I'm going

to do what I have to do to

benefit myself.'

She said, 'I feel so bad for

you.

Why'd it have to be your

health?'"

When I found out I had diabetes,

I was very shocked.

I thought that was something

that only older people got.

I was 12 years old.

I thought I was like, the only

person that got it at such a

young age.

I didn't know anybody else who

had had it.

I thought that everything was

going to be downhill from there.

I thought I wasn't probably

going to get past my 30s.

"I said, 'Stop apologizing; this

isn't taking over my life,

just one part of the many that I

will overcome in this fight.'"

Diabetes is only a problem if

you don't take care of it.

I just ate healthier and became

more active.

I joined basketball.

I like playing basketball

because it just keeps you on

your toes and it's a very

fast-paced game.

I don't like playing with girls.

When I play against guys, it's

more of a challenge and it gives

me more like... more motivation

to walk onto the court and be

like, "Okay, I need to beat

him."

I started college three months

ago.

I love college.

I love how I have a lot of

responsibility, because it makes

me feel like more of an adult.

One of the dining halls is just

a buffet, so when I go to eat,

it's sort of like a little kid

in a candy store.

Like, I can have anything that I

want.

In the beginning, it was hard,

because I was like, "Ooh, they

have pasta and they have chicken

and they have hamburgers and

then they have a salad bar and

they have like, an ice cream

machine and they have

everything.

I've gotten a lot better with

choosing what I eat and portion

sizes, so I've learned how to

control what I eat and not just

get... have like a free-for-all.

Eating healthier and just

exercising, I lost a lot of

weight and it was really

encouraging.

Diabetes does not define who I

am.

When I look in the mirror, I see

somebody who is very

strong-willed, and I see

somebody who knows what they

want in life and isn't going to

let anybody stop them.

"So when people say they're

sorry, tell them don't worry--

you just need their support

because the ball is in your

court."

>> HINOJOSA: Misty Anaya, thank

you so much for joining us on

the show!

>> ANAYA: Thank you for having me.

>> HINOJOSA: It's great to have

you.

So you're 12 years old, right,

you're growing up...

>> ANAYA: Yes.

>> HINOJOSA: ...and everything

is fine-- you're feeling fine.

>> ANAYA: Mm-hmm.

>> HINOJOSA: And then suddenly,

what?

You end up going to the doctor?

Was it a...

>> ANAYA: Well, one of my rel... one of

my younger siblings was

diagnosed with hypoglycemia, and

then... so we had a sugar kit in

the house, and then we went to

dinner one night-- we went to a

buffet-- and then we came back

and my face was so red and I

just wanted to go to sleep.

And my mom said, "No,

something's wrong with you."

So we had a sugar kit in the

house from my sibling, and then

she checked my sugar and it was

356.

>> HINOJOSA: Oh, my god!

>> ANAYA: Yeah, so...

>> HINOJOSA: What... how is it

that your family kind of knew to

check your sugar?

>> ANAYA: Because my younger sibling...

>> HINOJOSA: They thought that

maybe, perhaps, there was

something there?

>> ANAYA: Yes, and also, a whole bunch

of like, all of my other

relatives, pretty much,

everybody has diabetes.

>> HINOJOSA: So at that moment,

when... do you then go to the

doctor?

>> ANAYA: Mm-hmm.

>> HINOJOSA: Right.

And the doctor says to you...

you're 12 years old and the

doctor says, "Misty, you have

diabetes."

>> ANAYA: Mm-hmm.

>> HINOJOSA: What went on for

you at that moment?

>> ANAYA: I was really scared.

I was nervous, because I knew...

one of my other relatives, she

didn't take care of her diabetes

and she had a lot of

complications, and so I was

scared.

I was thinking that I wasn't

going to live... like, I had my

whole life planned out-- I've

always been like that-- and I

just thought that my life was

going to be shortened and that I

wasn't going to... yeah.

>> HINOJOSA: So the first thing

you heard is, "You are a person

with diabetes."

"My live is going to be shorter

than everybody else's.

>> ANAYA: Mm-hmm.

>> HINOJOSA: Okay, Dr.

Caballero-- reality check.

For a 12-year-old, that kind of

response of, "Oh, my god; I've

got this illness, I'm 12, I'm

not going to make it."

>> CABALLERO: Well, it's a very natural

thought.

The good news, however, is that

nowadays, if you control

diabetes-- even if you start

very early in age as Misty did--

you have a very good opportunity

to really have a very normal

life and prevent complications.

But...

>> HINOJOSA: But there is a

sense out there that it's...

>> CABALLERO: Of course, of course, because

actually, diabetes has been

associated with a reduction in

life span for many people,

because diabetes can lead to

complications.

But every time that we talk

about it, it is not just

diabetes per se, it's

uncontrolled diabetes.

>> ANAYA: Yes.

>> HINOJOSA: Okay, so what did

the doctors to say to you?

Then suddenly, at what point,

Misty, did you say, "Okay, I've

got an illness...

>> ANAYA: Mm-hmm.

>> HINOJOSA: "...but if I listen

to my doctors and all of the

experts..."

>> ANAYA: Mm-hmm.

>> HINOJOSA: "...they tell me

that I can really control this."

>> ANAYA: Mm-hmm.

>> HINOJOSA: And they said what

to you, in terms of changing

your lifestyle?

>> ANAYA: They said one thing I had to

change was my nutrition, because

I was... when I was diagnosed

with diabetes, I was very

overweight-- well, not "very,"

but I was overweight for my

age-- and they told me to cut

out all the soda and juice that

I was drinking, stop eating a

lot of fatty and greasy foods.

And I changed... in the first

week I lost six pounds just from

cutting out soda and changing my

nutrition, so...

>> HINOJOSA: Okay, so let me ask

you something, Misty.

>> ANAYA: Mm-hmm.

>> HINOJOSA: A typical...

because I've seen kids in our

barrios-- in our

neighborhoods...

>> ANAYA: Mm-hmm, mm-hmm.

>> HINOJOSA: ...and it just does

a number on me when I see them

at 8:00 in the morning and

they've got a can of whatever

soda...

>> ANAYA: Mm-hmm.

>> HINOJOSA: ...fill in the

blank.

Sometimes it's actually, you

know, the most sugariest of the

sugariest...

>> ANAYA: Mm-hmm.

>> HINOJOSA: ...and they're

eating some, you know, potato

chips or something or another,

and this is breakfast.

Tell me what, let's say,

breakfast or lunch.

>> ANAYA: When I was younger, I usually

ate cereal before I went to

school.

It wasn't that... but it was,

like you said, in those... in

like, especially Latino

communities, there's a lot of

bodegas and corner stores

everywhere and they sell chips,

ice cream, juice, sodas, all

junk food.

>> HINOJOSA: And kids love that

stuff.

>> ANAYA: Mm-hmm.

>> HINOJOSA: So when you were

told, "Misty, you need to just

get rid of all that stuff," did

you just think, "Well, that's

impossible; that's what I eat!

I'll never survive if I don't

eat that stuff."

>> ANAYA: ( laughing )

I was... because I didn't know

what else to do, so like, even

when like, my mom went food

shopping, because there was five

kids, she just bought like,

chips and stuff.

And so I started eating a lot

more fruit cups, and I would be

like, the only one on my school

bus.

>> HINOJOSA: How has it changed

you?

What has it done to you?

Because a lot of people say

sometimes, when you get a

certain illness or diagnosis, it

changes you as a person-- not

just in terms of your health,

but as a person.

So what has it done for you?

>> ANAYA: It's definitely made me more

responsible and I've matured a

lot faster and it's also made me

appreciate life more.

>> HINOJOSA: And what would you

say is the biggest thing that

you've had to change?

So it's about what you eat?

What other things, like your

life?

>> ANAYA: I would say it's... it's made

me... everything that I do, I

have to watch to make sure I'm

managing my diabetes well.

So even if it's before playing a

sports game I have to make sure

my sugar's okay, when I go to

social events-- especially now

like, I'm in college, there's a

bunch of social events.

I have to make sure that I make

smart decisions.

If I go somewhere, I always have

to make sure I have my sugar kit

on me in case it drops, and

juice.

Like, if... everything that I

have to do, I have to think

about, "Is my sugar going to be

okay?"

>> HINOJOSA: But do you think

it's a burden, or you're just

like...

>> ANAYA: I'm used to it now.

It's not so much of a... it's

not a hassle.

You know, diabetes isn't my

life.

>> HINOJOSA: When kids in the

'hood, let's just say...

>> ANAYA: Mm-hmm.

>> HINOJOSA: Is there a lot of

teasing that's going on around

the issue of diabetes?

Like, "Oh, you're overweight--

you're going to have it; it's

your fau..."

What's the kind of vibe?

>> ANAYA: The vibe espe... like, where

I'm from there's not so much

teasing, but I definitely think

there's a lot of teens out there

that have it that don't know

that they do.

I notice that, because even with

the obesity and the dark spots

behind their necks, and... like,

I... and then some of my friends

are like, "Oh, I don't feel

good.

I feel like I'm going to pass

out."

I'm like, "Well, when did you

eat?"

"Yesterday."

Well, you know?

So I think there's a lot of

people out there that have it

that don't know they do.

>> HINOJOSA: So... and also just

kind of a misinformation or

miseducation, like...

>> ANAYA: Yeah, yeah, they're not

educated about it.

>> HINOJOSA: You have to eat,

like you can't...

>> ANAYA: Yes, yes.

>> HINOJOSA: Like, meal is not

soda and chips and then you

don't have to eat again...

>> ANAYA: Until hours later.

>> HINOJOSA: ...until the next

day.

>> ANAYA: Yeah.

>> HINOJOSA: Dr. Caballero, when

you hear these stories, when you

hear Misty's story, again, it's

a tremendous challenge.

You've got a lot of food

marketers who are out there,

wanting to ca-ching, ca-ching,

ca-ching, and you're saying if

we keep on doing this, it's

actually, in terms of our health

care system, it's going to cost

us... billions?

>> CABALLERO: Oh, yes.

Well, diabetes, Type 2 diabetes,

is a major problem.

It's an epidemic issue in...

around the world, basically.

In the U.S., for instance,

according to the statistics, we

spent $174 billion in the year

2007 in treating diabetes.

Now, the problem is not just the

amount, which is about 14% of

all the health care dollars

available in the country, is

that 80% of all that money was

dedicated to the treatment of

the complications of diabetes--

not the disease.

We're treating the consequences

of diabetes.

>> HINOJOSA: Which are?

>> CABALLERO: Heart disease, blindness,

amputations, renal kidney

failure, dialysis...

>> HINOJOSA: But that seems...

>> CABALLERO: So we are spending the money

in the late stages of the

disease.

>> HINOJOSA: It seems so

contradictory for an... a

medically advanced society to be

treating kind of the

consequences of a disease.

But if you had control...

>> CABALLERO: Yeah.

>> HINOJOSA: ...what would you

say?

What needs to change in terms of

kind of the health care managing

of diabetes?

>> CABALLERO: I would just reverse the way

we are spending the money.

I would dedicate probably 80% of

that in the prevention of the

disease-- in identifying people

early on and provide the best

type of approach and treatment

to prevent the development of

complications.

So for instance, there are some

statistics that suggest that

probably about 30% or 40% of

children and adolescents in this

country are overweight or obese.

That's one in three or one in

two in some of the racial and...

that's exactly what Misty says.

>> HINOJOSA: And you saw a lot

of that in your community?

>> ANAYA: Where I've grown up, yeah.

>> HINOJOSA: Kids who are just

too overweight.

>> ANAYA: Mm-hmm.

>> HINOJOSA: Okay.

>> CABALLERO: And the CDC, for instance,

released a couple of years the

staggering statistic that for

children born in the year 2000

or afterwards, the lifetime risk

of developing Type 2 diabetes is

about 35% to 50%, so that's

huge.

It means that for all the young

people, all the children right

now that we have in our

households have a huge risk of

developing diabetes, unless we

do something about it.

And the only thing that we can

do is to change our lifestyle.

Because remember, there's a

genetic tendency for diabetes.

We can't change that.

In Misty's case, she comes from

a family that is, you know,

partially Hispanic.

We know that that's a high risk

population.

We can't change that, but we can

change our lifestyle.

We can improve the way we eat,

we can become more physically

active, we can educate ourselves

as to what we can do within the

limitations that we may have.

It starts in the family, it's a

societal issue, but that's where

I would put all the money, all

the efforts, all the

responsibility in identifying

people at risk.

It makes no sense to wait until

the problem is too late.

>> HINOJOSA: Misty, we've got

just a few seconds left.

So tell me, what is your dream?

>> ANAYA: My dream is to make other

teenagers aware of diabetes and

just let them know that it's

not... diabetes is only a

problem if you don't manage it

well.

It doesn't have to be an issue

in your life, and I want to

aware other teens that don't

have diabetes as well.

>> HINOJOSA: Okay, and Dr.

Caballero?

>> CABALLERO: Well, Type 2 diabetes can be

very well controlled, and we can

prevent the complications.

That's very important.

But the best approach is to

prevent the disease.

So who's at risk?

People with family history of

Type 2 diabetes, people that

belong to the ethnic and racial

minorities, women with history

of gestational diabetes, people

with high blood pressure, people

with high fats in the blood--

triglycerides, cholesterol, et

cetera-- obviously, people that

are overweight or obese and

people that have what we call

prediabetes-- elevated blood

sugars not at the level for

diabetes yet.

That's where we have to do

things-- to do things early on

and aggressively to prevent the

problems.

So intervention as early as

possible.

And education-- education is

key.

>> HINOJOSA: See your doctor,

eat well, lots of exercise, and

for more of Misty's story, you

can actually go to

pbs.org/mytype2 where you can

see a lot more stories about

young people

dealing with diabetes.

And for both of you, thank you

so much for joining me.

>> CABALLERO: Thank you for having us.

>> ANAYA: Thank you.

>> HINOJOSA: Continue the

conversation at

wgbh.org/oneonone.