March 27, 2019

CHRISTIANE AMANPOUR: Hello, everyone, and welcome to “Amanpour and Company.” Here’s what’s coming up.

Today we put wellbeing in the spotlight. First —

(BEGIN VIDEO CLIP)

NANCY PELOSI, U.S. HOUSE SPEAKER: The GOP will never stop trying to destroy the Affordable Health Care of America’s families.

(END VIDEO CLIP)

AMANPOUR: Health care takes center stage in the post Mueller world. I’ll speak with Senator Chris Murphy of Connecticut.

Then —

(BEGIN VIDEO CLIP)

SANJAY GUPTA: We spend more on health care than any other country in the world and our life expectancy continues to go down.

(END VIDEO CLIP)

AMANPOUR: One nation under stress. Dr. Sanjay Gupta on what’s fueling America’s deaths of despair.

And —

(BEGIN VIDEO CLIP)

GABBY DUNN: I thought it would help people to understand how mental health contributes to finances and maybe —

(END VIDEO CLIP)

AMANPOUR: Why it’s OK to admit that you’re bad with money. Author Gabby Dunn talks to our Alicia Menendez about a big modern-day taboo.

Welcome to the program, everyone. I’m Christiane Amanpour in London.

The post Mueller America sees health care at the top of the agenda for both parties in ways that will define the 2020 election. The president has

wasted no time directing his Justice Department this week to get the courts to entirely strike down Obamacare, which is formally known as the

Affordable Care Act.

Here’s the president and his main sparring partner, House Speaker Nancy Pelosi.

(BEGIN VIDEO CLIP)

DONALD TRUMP, U.S. PRESIDENT: We are going to be the Republicans, the party of great health care. The Democrats, they’ve let you down.

PELOSI: The Department of Justice becomes the department of injustice when it wants to tear down health care benefits, because as Dr. King said,

people could die.

(END VIDEO CLIP)

AMANPOUR: Now, in the run up to the midterms, 80 percent of voters said that health care was very important to them, and that included 68 percent

of Republicans. It comes as real-life health issues hit home. First, Rockland County in the State of New York is banning unvaccinated children

from public places after a months-long outbreak of measles. And three high profile suicides in just over a week of putting a spotlight on mental

health and gun violence to survivors of last year’s high school massacre in Parkland, Florida have taken their own lives, and the father of the victim

in the Sandy Hook School shooting has died in an apparent suicide as well.

Senator Chris Murphy is close to both these sad stories and has helped put health care for Americans at the top of the political agenda. And I’ve

been speaking to him about all of this from Washington.

Senator Murphy, welcome to the program.

CHRIS MURPHY, U.S. SENATE DEMOCRAT: Thanks for having me.

AMANPOUR: So, what is the state of play? You heard us set this up as the Democrats and the president vowing to make health care the issue and for

each of your parties to claim to be the party of health care. What do you make of that as a winning issue for the next election?

MURPHY: Well, you know, no politician needs to make health care the issue, it is the dominant issue when you’re talking to constituents. When I’m

back in Connecticut, everybody is talking about how their health care is more expensive than ever before, drug prices are spiraling, the opioid

epidemic is out of control. And it seems that President Trump and administration are just trying to make it worse.

You know, I mean, everybody knew that the Affordable Care Act was imperfect but when the Trump administration or Republicans tried to get rid of it

without any replacement, without any idea as to what comes next, it exposed the fact that Republicans were really pretty ideological about this, they

just wanted a bill with the president — with President Obama’s signature gone and didn’t have any idea what to do next.

And President Trump, of course, has been really consistent. Since he got into office, he has been doing everything he can from the White House to

try to destroy the Affordable Care Act, and this week was the latest development. He instructed all of his lawyers, the Department of Justice,

to go to court to try to invalidate immediately the entire Affordable Care Act, that would mean 30 million people losing insurance overnight, that

would mean everybody with (INAUDIBLE) and conditions having their rates checked up or losing insurance completely, and this was a change.

It used to be that his lawyers were going to court to just try to get rid of some parts of the Affordable Care Act. Now, he wants the whole thing

gone and again, has no plan to replace it. So, you know, the stakes are pretty high right now.

AMANPOUR: So, let’s put it in the president’s own words because he addressed this very issue today in Washington. Here’s what he’s saying

about this.

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TRUMP: We’re coming up with plans. We have a lawsuit right now going where phase one of the lawsuit. terminates Obamacare, essentially terminate

Obamacare, you know that that’s the Texas lawsuit. We think it will be upheld and we think it will do very well in the Supreme Court.

And if the Supreme Court rules that Obamacare is out, we will have a plan that’s far better than Obamacare.

(END VIDEO CLIP)

AMANPOUR: OK. So, there are two issues there. The last time it came up to the Supreme Court, the Supreme Court upheld the Affordable Care Act.

Isn’t that right? And do you believe that the Supreme Court will seek to throw it out if it comes up again?

MURPHY: So, the exact same five justices that up held the suit — the constitutionality of the Affordable Care Act are still there. So, you

would suppose that nothing would change. Now, there are a couple, you know, political operatives on the Supreme Court right now in the

(INAUDIBLE) Brett Kavanaugh who were going to try to come up with new and novel arguments to strike down the Affordable Care Act. So, I don’t think

we should assume it’s completely safe.

But as to his second point, which is that, “We’re going to come up with some new plan,” that was what the entirety of 2017 was all about. All

throughout that year, Republicans were working on coming up with a plan to replace Obamacare and they didn’t come up with one. Which is why in the

end, their effort to repeal the Affordable Care Act sell by the wayside.

So, Republicans have been using this, you know, rhetoric about coming up with a replacement for Obamacare for 10 years. They have no replacement,

they have no plan, they are never going to have a plan, and the president knows that. All he’s going to do here is just rip the insurance away from

30 million Americans and there will be absolutely no substitute for what comes next.

AMANPOUR: Obviously, it was a major winning issue for the Democrats in the midterm elections, it was the top of just about everybody’s list of

priorities. So, this is what a Republican Senator, Susan Collins, said today about the president’s current plans.

(BEGIN VIDEO CLIP)

SUSAN COLLINS, U.S. SENATE REPUBLICAN: If the administration is opposed to the ACA, and clearly, there are provisions of the law that do need to be

fixed, the answer is for the administration to work with Congress and present a plan to replace and fix the law, not to — through the courts to

seek to invalidate it altogether.

(END VIDEO CLIP)

AMANPOUR: So, if this does get down to a legislative, you know, through the courts and through Congress battle, what do you expect, what kind of

reaction do you expect from your Republican Senate colleagues? You see what Susan Collins says but there are others who are much more tacking

towards the president’s line.

MURPHY: Yes. I mean, Susan Collins is a major outlier, right. She’s one of only three Republican senators who voted against the repeal of the

Affordable Care Act with no replacement. Most Republicans have been broadly cheerleading the president’s attacks on the Affordable Care Act and

I expect that that will continue.

We did come together about a year-and-a-half ago to come up with bipartisan legislation that would reverse some of Trump’s attacks on the Affordable

Care Act, would make sure that the insurance companies get paid, would restore the marketing money for the exchanges that he canceled, but he made

it very clear he wouldn’t sign that law. And so, Republicans upon hearing that decided not to move it forward.

But it does speak to the fact that there is ability to get Republicans and Democrats to agree on health care policy. With this president though,

there’s no way to get it signed into law.

AMANPOUR: It was notable that many members of the Democratic party, whether in Congress or in the Senate in the post Mueller days, these last

few days of this week, have not wanted to talk about going down a rabbit hole of keeping on investigating the Mueller report (INAUDIBLE), they’ve

really kept focus. Particularly in the House, we’ve heard on the issues and they have been health care. Do you believe that that’s a strategy that

will hold across the Democratic party going forward?

MURPHY: Well, let me just say, I don’t actually think the post Mueller days commence until his report is before Congress and the American people.

So, right now, only a handful of people know what’s in that report. I have no way to evaluate whether there are serious allegations of fraud or

illegality in that report that we have to take action on.

So, right now, it’s really important for us to make sure that the Trump administration doesn’t continue to succeed in hiding in this report from

the American public.

That being said, I don’t know of any Democrats running for contested seats for Congress in 2018 who ran political ads on the Russian investigation.

They were running ads on gun policy, on health care, on immigration. And so, well, the Russian investigation has always been super important, it has

not ever been top of mind for our constituents, economic issues have been and that’s why we won in 2018 and the House of Representatives because we

focused on those issues and that’s where most of our focus will continue to be, and I think that’s right.

AMANPOUR: I mean, you’re absolutely right. Again, the stats show that the Russia issue was practically the last issue on voters’ minds during the

midterm election. But do you believe that the full Mueller report will be released? I know that’s a topic of big conversation right now.

MURPHY: I don’t know whether the report is going to be released. I get more and more concerned every single day. I had assumed that it would be

immediately sent to Congress at the same time that the attorney general was reviewing it. And every day that it doesn’t come to Congress, I think

should make all of us worry about what’s actually in that report and whether the attorney general is telling the truth in his suggestion that

there is no evidence of collusion and no actionable evidence from a criminal standpoint on obstructions.

So, I’m less confident than I was yesterday and the day before that we’re ever going to see that report. And, you know, this is the future of

democracy. If the American public and Congress can’t see this report, then I don’t know how you ever investigate a president ever again if the

administration can control that entire process and control who sees the findings.

AMANPOUR: Senator, can I get back to the broader health issue. Beyond the Affordable Care Act there is a current — well, some would say a crisis in

the United States, the World Health Organization list vaccine hesitancy as one of the top 10 global health threats of 2019, about 30 percent worldwide

increase in measles and it’s now come to the United States with this issue in New York State where the kids who’ve been unvaccinated are banned from

public spaces, can’t go to school and all the rest of it because there is an outbreak of measles.

Tell me how this is going to be addressed in the United States and can you separate a real health necessity of vaccines from the political sort of

playing around with anti-vacs theories and social media conspiracies?

MURPHY: Well, I think that our committee, the health committee in the Senate has shown that you can separate the politics on this issue from the

policy. Senator Alexander, a Republican, who often comes to the defense of President Trump, convened a hearing in which there was no diversity of

opinion amongst the panelists. Every single person there was representing what is the scientific communities’ definitive conclusion, which is that

there is no harm in individuals taking vaccines and that the only harm comes through people just choosing to forego vaccinations.

So, I think with the Senate, we have really tried to keep the politics out of this. It doesn’t help that the president, you know, has in the past

done business with some of this anti-vaccination crowd. But, you know, we’re going to try in the Senate to make it clear that every single

senator, Republicans and Democrats, is ready to take on this conspiracy of lies about what vaccinations do and that we are willing to do anything that

is necessary in order to stop these measles outbreaks, these rubella outbreaks from overtaking communities in this country.

AMANPOUR: I mean, let’s just delve a little bit into how you stop these mid spreading, because it is extraordinary that Europe, for instance, is

seeing a 20-year high in the spread of measles and we’ve seen that President Trump has tweeted many, many times about the connection, the

supposedly connection, between the MMR vaccine and autism. And indeed, other populist leaders are jumping on these anti-vacs bandwagon, whether

they’re in Italy or in France or elsewhere.

What is a successful way to combat this because it’s so serious in terms of people’s health and their lives?

MURPHY: Well, one piece of legislation I think is going to be worthwhile to take a look at in the United States Senate is regarding the exemptions

that people use to get out of taking vaccinations. Many states have wide open malleable exemptions in which people don’t really have to answer many

questions about why they are choosing to withhold their children from a particular vaccination.

We can tighten these exemptions, we can make people receive some education first before they use one of these exemptions, and maybe that will limit

the number of people who end up going through with a decision to withdraw their children. So, that’s one I think really important step that we could

take from a policy standpoint.

AMANPOUR: Can I move on to other aspects of health, and this is mental health and the spike in suicides in the developed world. I mean, it really

is a tragic, tragic issue. Since Sandy Hook, it took place in your state, you have been very, very proactive in trying to combat gun violence, trying

to lobby for sensible a gun law. But there’s also human fallout still, we’ve seen two suicides amongst Parkland School survivor. We understand

that one of them, according to her parent, had survivor’s guilt.

And we also understand, we believe that one of the fathers of a Sandy Hook victim, Jeremy Richmond, took his own life and his wife has tweeted, “It’s

318 a.m., I can’t sleep even when wrapped in the arms of my beautiful children. Insidious and formidable that tricks the brain took his grief

and killed him, my champion. I will love you forever, Jeremy Richmond,” and the hashtags.

Senator, you knew Jeremy. Just give us a sense of what could have led to this terrible tragedy that — I mean, he was fighting so hard with his

foundation.

MURPHY: Yes. I’m not the right one to try to explain Jeremy’s death. He was a friend, he was sitting with me in my office just a few weeks ago,

more enthusiastic than ever about the work that his foundation named after his daughter, who was killed in Sandy Hook, was doing. And it’s a reminder

of how difficult it is to manage the fallout from these tragedies.

People say, “Well, it just underscores why we need to get help to people who are going through this kind of grief.” Well, Jeremy was actually the

person that you called in order to get help for people who are managing grief, he ran a foundation that was dedicated to helping people understand

the way the brain tricks you into doing harm against others or against yourself. Nobody knew the neurology of aggression and harm better than

Jeremy Richmond, and he still couldn’t stop himself from making decision to end his life.

And so, it is a reminder of why prevention is really the only way forward. You have to pass laws like universal background checks and bans on assault

weapons that stop these tragedies from happening in the first place. Because trying to manage the trauma that comes afterwards is like trying

to, you know, put your finger in an exploding dike. It’s ultimately worthwhile but it is not going to make the impact that prevention will.

AMANPOUR: And just finally overseas, another huge health related issue and that is what’s happening in Yemen. I know that you and the Senate are very

concerned about the U.S. backing of this war, the ongoing war there. A Save the Children facility has been bombed and kids have been killed. What

is your reaction to — I don’t know, to trying to get this to come to an end, to try to get the U.S. backing of it to end?

MURPHY: I mean, I don’t know how the Saudis bomb a hospital, a children’s hospital, after all of the attention on the just cascading catastrophes

that has been their participation in this war. And it’s just more evidence that the United States needs to get out.

We need to get out because we cannot participate in war crimes any longer, we need to get out because so long as the Saudis think that we are still

relatively unconditional on our support for them in the Yemen war, we are never going to force them to come to the negotiating table.

Now, the Houthis are incredibly bad actors, they have been stopping much of the implementation of the Stockholm Agreement from going forward. But the

Saudis, by and large, have been the ones on the outside of the negotiating process.

So, from a position of promoting peace and from a position of human rights, the United States needs to get out. There will be legislation landing on

the president’s desk in a matter of days that will require the United States to get out of the Yemen war supported by Republicans and Democrats.

I hope he rethink his stated opposition and decides to sign it, especially after this news of another children’s hospital being bombed by the Saudis.

AMANPOUR: Senator Chris Murphy, thank you. And of course, you’re a co- sponsor of that in the Senate. Thank you very much for joining us today.

MURPHY: Thanks for having me.

AMANPOUR: And we turn back and dig deeper into a main topic today, which is health care in America, where something unique and scary is happening.

The U.S. spends more on health care than anywhere else in the developed world and yet, life expectancy has actually been going down for three years

in a row now according to the Centers for Disease Control and Prevention.

Dr Sanjay Gupta attributes much of the epidemic to deaths of despair. And his new documentary for HBO is called “One Nation Under Stress.” Here is a

clip from the trailer.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: Stress is an epidemic of monstrous proportions.

UNIDENTIFIED MALE: What’s the surest way to make our (INAUDIBLE) feel poor, put him in a lot of income and equity.

UNIDENTIFIED MALE: Not only do you feel helpless, you feel rich.

UNIDENTIFIED FEMALE: It just seem like we didn’t matter.

UNIDENTIFIED MALE: People have this ideology that the competition is good for you, but that’s a trick.

UNIDENTIFIED MALE: Could it be that a society get so stressed out that it actually starts to break?

(END VIDEO CLIP)

AMANPOUR: And Dr. Sanjay Gupta joins me now from Atlanta.

Welcome to the program, Sanjay.

SANJAY GUPTA, NEUROSURGEON: Thanks so much for having me. I really appreciate it.

AMANPOUR: This is really, really a topical and timely investigation that you’ve done. It’s amazing. Before I just get into that, I want to get

your medical opinion on what I was asking Senator Murphy about, which was this outbreak of measles and the anti-vacs hysteria that is causing real-

world impact.

GUPTA: Well, you know, one thing I think when we talk about the anti-vacs hysteria, it is worth sort of looking a little bit in context. I think for

the vast majority of people, Christiane, thankfully, still do vaccinations, they get themselves, their children vaccinated, they understand the

science, they see the benefits and they also understand that when they get vaccinated, it’s not just for themselves, not just an individual

protection, but it protects groups of people, that’s — they herd immunity that you certainly talked about in your program, people talk about.

I think — but you do see the impact in certain communities now within the United States of not getting vaccinated and not having that herd immunity.

And the measles, in particular, is something that, as you know, in the United States, was deemed eliminated in 2000, year 2000s, so 19 years ago.

And now, we’re dealing with this again. One community North of New York, 153 cases. Now, since October, 50 cases just this year. And again, as

you’ve heard, they’re taking some extraordinary steps now to try and curtail that.

But the science is very clear. The science is very clear on this. I mean, there’s some things where the science is squishier, we need more science,

we say that a lot in the medical world. Here, there’s large studies, there’s large meta analyses to determine both the benefit of vaccines and

the lack of adverse, you know, negative side effects.

So, you know, I have three kids, I got to them vaccinated on schedule, Christiane.

AMANPOUR: I did as well, right at the top and the height of this, you know, MMR scandal. And we’re seeing the fallout now.

Just quickly, another question on this, because we’re hearing from — basically reporting, that this apparently — this outbreak, started in the

ultra-orthodox Jewish communities in Rockland, many with close ties to the Brooklyn areas where they’ve also been infections, and vaccination rates,

apparently, in those communities tend to be lower and anti-vaccination literature has spread, according to public officials. And another report

saying this outbreak began when an unvaccinated resident visited Israel and became infected there and returned home with the disease.

So, in terms of you as a doctor and you as a journalist and the health care community, how does one counter the spread of these this fake literature,

these myths, these untruths about the science?

GUPTA: I think that there’s — there is a lot of knowledge that is circulating that talks about the benefits of vaccination as well. What you

find — and look, no one knows this better than you, Christiane, because you’re the you’re the one we all look to when it comes to communicating

important messages.

But, you know, sometimes people hear what they want to hear. And I know that sounds rather glib but I — you know, as much — as long as I’ve been

doing this job, I find that sometimes it’s not that people aren’t getting the messages, it’s that they’ve already made up their minds and they look

for things to reinforce their point of view. And if someone is already suspicious or does not want to get vaccinations and anti-vaccination

literature is — finds their way to them, they’re going to read it. Whereas, people who trust the science, they don’t read this.

You do find, for example, within this community, North of New York, this more orthodox Jewish community, that religious leaders, rabbis, others have

come out themselves and said, “Look, if you are not doing this because of religious reasons, because you’re claiming an exemption for religious

reasons, that’s not a good reason to do it. That’s not something that the Orthodox community is advocating.”

So, even with that though, you still see I think around 80, 82 percent percentage of people who are getting vaccinated, which is too low to get

this herd immunity that we talk about. You need to be over 95 percent for that. So, that’s the problem.

But, you know, I wish I could have a better answer for you, Christiane, about how to really reach people who have made up their minds already that

they think vaccinations are harmful, they’re bad, they’re not affected, whatever their argument maybe, it can be very challenging at times.

AMANPOUR: Well, it’s right that their religious leaders are saying, you know, what you’re saying that they do. And of course, this is also around

the world, the Gates Foundation and others are very upset that in Muslim countries there’s all this suspicion about polio and kids are not being

vaccinated, whereby they should, and these are small pox and all the rest of it, diseases that have been eradicated and they’re coming back.

Thankfully, it’s small but the WHO recognizes it as being a real major problem for this year.

GUPTA: Correct. Yes.

AMANPOUR: I want to move on, because it is related in various different ways to your incredibly interesting and timely documentary and how

extraordinary it is to hear in the same sentence that America, the most developed, powerful, richest country in the world, which spends the most

of any other country on health care is seeing the — I believe, the fastest and slightly consistent falling of life expectancy. This is not meant to

be happening in the United States. Tell us about it.

GUPTA: Yes. I mean, you can’t even believe it and the people who first noticed this trend, economists out of Princeton, they literally had to, you

know, look at the numbers several times, they don’t believe it themselves.

The fact that the United States has now dropped in life expectancy three years in a row, the only country in the developed world where this is

happening. The last time this happened, Christiane, in the United States was a hundred years ago.

And what was happening a hundred years ago, we were in the middle of a world war and a global flu pandemic. So, just to give you some context.

AMANPOUR: Wow.

GUPTA: We spend trillions of dollars on health care, twice as much per capita as the next — you know, the country that spends the next amount.

And so, it’s really unbelievable.

And if I can for a second, because we really dug into this, not only is the United States the only country in the world where this is happening, but if

you start to now look at the demographics within the United States, the largest populations, African-Americans, Whites, Hispanic-Americans,

Hispanics, you find that with African-Americans, their mortality rates are higher than Whites but the mortality rates have been going down steadily.

Hispanics, mortality rates are actually lower than Whites and they continue to go down. So, it’s really Whites and primarily working-class Whites,

which is defined as having a high school education or less, that is driving this trend.

If you look at every population in the developed world, Christiane, every population in the developed world, all of them have been steadily

increasing in life expectancy since World War II, except for one.

AMANPOUR: These are really —

GUPTA: The only where that’s not happening is the White working class.

AMANPOUR: It really is extraordinary. And I want to get to that in the whys. But first, I want to play a clip where you talk about this

phenomenon as the deaths of despair. It’s a very, very punchy and visual title. And here in this clip, you’re explaining it.

(BEGIN VIDEO CLIP)

GUPTA: The CDC says that middle-age Whites have the highest increase in these deaths of despair. The CDC folks also noted the high rates of drug

overdose in this group.

When I first started looking at these spikes and different causes of death among the White working class, opioid overdoses, suicides, cirrhosis of the

liver, it felt a bit mysterious to me. It took some time still to sort of piece it together and say, “Whoa. Wait a second, there’s something going

on here.”

(END VIDEO CLIP)

AMANPOUR: So, that something going on is the investigation. And perhaps the title and the reason is contained in your title, “One Nation Under

Stress.” So, you’ve identified the three sorts of deaths of despair.

GUPTA: Yes.

AMANPOUR: What is it and what kind of stress is it that causes this?

GUPTA: Yes. Yes. That was really the investigation. You know, much — I think this is a parallel between medicine and journalism. You see the

symptoms which are the opioid, primarily opioid overdoses and drug overdoses, suicides and liver cirrhosis due to alcoholism, and, you know,

they’re all self-inflicted, you know, deaths of despair, they’re self- medications that have led to death.

And this idea of stress being the common factor is what really started to emerge. And not just the kind of stress that people talk about from having

a busy day or even from time to time struggling with finances, which is the most common forms of stress, we’re talking about a much deeper sort of

stress.

This population, Christiane, the White working class, the White population of the United States, primarily oftentimes, the sons and daughters of the

greatest generation. I mean, their parents are literally called the greatest generation who went off and won the World War, came back and help

build America into what it is. And the expectation was that their sons and daughters, this population that we’re talking about, were supposed to

inherit the Earth, they were supposed to inherit the United States at a minimum and instead, they saw jobs leaving due to outsourcing and

automation, they saw wages dropping due to the changes in the global economy. And now, they see themselves dying at a faster rate than any

similar population in the developed world.

So, this is the kind of stress that is an identity stress, it’s an existential stress, it’s based on this — what psychologists refer to as

dashed expectations, to have expected something and not received it is far worse than simply not receiving it, and that was something that came up

over and over again. You know, the impact that these dashed expectations have on mortality.

AMANPOUR: And this — you’re a neurosurgeon. You pointed out with the graphics and the x-rays and the imaging of how it actually is a physical

thing, this stress. It’s not just a feeling and something that happens to you.

GUPTA: Right.

AMANPOUR: It actually affects the frontal cortex, I think. And you make this distinction between what you’ve just said, not everyday stress, but

this cumulative toxic stress.

GUPTA: That’s right. I mean, look, I think people talk about this aspiration that we want to eliminate stress. That is probably neither a

good nor a worthwhile aspiration. I mean we all need stress.

I mean certainly, any living creature needs stress in order to survive and thrive. So stress itself is not the enemy. That’s not the thing that

people should be pointing their finger at.

It is, as you say, the constant relentless nature that then turns that stress into a toxic stress. I was quite struck by this very objective

impact, measurable impact on the brain because I think oftentimes people think stress is a nebulous thing, how do you define it? Can you really

measure it?

What they showed me, and this is at the Yale Stress Center, was this area, the prefrontal cortex of the brain that starts to actually diminish in

size, wither away in its connectivity in response to stress. So they have put people in these MRI scanners and they’d expose them over and over again

to these stressful images.

So it wasn’t just one stressful image but it really put someone into a constant state of stress. And they saw these changes in their brain.

And why this is important is because that part of the brain is also a part of the brain that makes you resilient to more stress, makes you exercise

good judgment, makes you sort of figure out how to be empathetic toward your family, your friends, your colleagues, whatever. But even things like

— makes you more likely to make good decisions about your next meal in terms of your overall physical health.

So when you lose that part of the brain or it withers away, I should say, it becomes sort of a self-fulfilling thing. A constant sort of stress like

that makes you much less likely to be resilient to stress in the future. And you can sort of see the problem there.

I will say, if you allow me, just on a slightly more aspiration uplifting note, is that we used to think that once those areas of the brain were gone

or withered away, that was not going to come back. The same studies show that that’s not the case either, that you can regrow those parts of the

brain in response to stress mitigation, in response to having times without stress so that you can get yourself out of that cycle.

AMANPOUR: I want to dig down on one of the issues you’ve identified. Obviously, in terms of the depths of despair, there is liver cirrhosis

obviously from alcohol. There’s drug deaths and this epidemic of heroin and prescription drugs that are killing people. And there is suicide.

Let’s just take the drugs for a moment. And let me read to you these terrible statistics that you have in your program. Basically, the United

States makes up under five percent of the world’s population but uses some 80 percent of the world’s oxycodone and hydrocodone.

Nearly 50 Americans die every day of prescription drugs. And, of course, this is a big issue in the United States right now. Let us play a little

clip of a lady called Angela who you talk to a lot. And this is at her worst.

(BEGIN VIDEO CLIP)

ANGELA: I take way more than I’m supposed to. Even the other night, I was sitting there thinking, maybe I should just take all of these and just go

to sleep.

(END VIDEO CLIP)

AMANPOUR: I mean, again, it’s really sad because it was the stress of her life and her loss — her losses that caused her to take these drugs. Then

she became addicted to them.

But the good news, and we’re going to put this picture up, is that she did get treatment. And by the end of your documentary and after the years of

doing this, you see that Angela is so much better and she looks just completely different now that she’s in recovery.

Tell us about — we know the story, the painful story of America’s massive drug addiction. But tell us about how they get well, how some people can

get out of this.

GUPTA: Yes. You know, and I can tell you, you made so many films, Christiane. When we first met Angela, we really had no idea how she was

going to do. I mean we were very worried about her.

I mean She was talking about suicide, dying by suicide when we first met her. And she was — you can see how much weight she lost. We

get a real sense of her life. For her, you know, it really came down to a very strong social support system, you know.

This wasn’t a story that was solely rooted in the economy, someone who is living on the fringe, doesn’t have access to health care, losing their job.

She lived in a family where they had resources and she had health care. This wasn’t an economy or labor force story.

What we found was that ultimately for her, having strong social cohesion, being able to count on people within her family and her community, who

eventually got her help. She went to rehab. She went through recovery, learned stress mitigation techniques, was able to treat her addiction.

All those things ended up making a big difference. But if you had to look at probably the most important factor, it was this idea of the social

support. And when you look around at other countries around the world that have similar amounts of opium available — opiates available to their

population, they’re not taking these things, what are the big buffers? What are the big protective forces against that?

And you find that a lot of times it is the social cohesion. Social cohesion that didn’t happen by accident. It’s part of the culture. There

are policies in place to help promote it and foster it and nurture it.

But in many places in the United States, you just don’t have it. So you’re suffering. You find easy ways to try and self-medicate with medications.

You get the prescriptions. You start to take more and more of that. You’re at real risk of death.

And what is the thing that’s likely to pull you out of that? The umbrella thing really is strong social support.

AMANPOUR: I really —

GUPTA: Luckily, Angela had that.

AMANPOUR: I really found that fascinating because you did, even more, digging into the idea of community and people will see that when they see

your documentary on HBO. And it’s really, really fascinating.

And of course, it makes sense that community and those communities have much less heart failure, much less, you know, congestive issues in their

body. And I really think that’s interesting.

But I want to also ask you about the naturalist professor from Stanford who you interviewed, and also the story about the monkeys because these baboons

that he talked about when they had stress or grief, how they healed was by grooming each other.

So there, again, is the social cohesion in the community. But there is also an issue that another naturalist who you talked to, Frans de Waal

depicted in a Ted Talk and this inequality. Inequality is something that really upsets millennials and people. And it’s kind of the story of our

world right now.

But he showed it through monkeys who were being given a different sort of treat for a test. Let’s just have a look.

(BEGIN VIDEO CLIP)

FRANS DE WAAL, DUTCH PRIMATOLOGIST: So she gives a rock to her, that’s the task. And we give her a piece of cucumber and she eats it. The other one

needs to give a rock to us and that’s what she does. And she gets a grape and she eats it. The other one sees that. She gives the rock to us now.

Gets again cucumber.

(END VIDEO CLIP)

AMANPOUR: I mean it’s perfect. The rage of unequal pay and inequality gap. You’ve delved into so much, just sort of described this as one of the

main factors in stress. And then finally, you know, what is your advice to de-stress, to try to buffer, as you say?

GUPTA: Yes. And I would just say about the monkeys, you know, it’s interesting because the — obviously, you can see the monkey that’s

receiving the cucumber very upset, literally rattling the cage. Subsequent studies have shown, and this is an important point, that the grape-

receiving monkey, the one that got the better treat, also had stress levels that skyrocketed.

It seems no matter where you lie on the spectrum, whether you are a have or have not, you’re wealthy or you’re not, living in a glaringly unequal

society can be very disruptive, very unstable, and very stressful. And that’s not a comment on capitalism versus socialism because there are

plenty of capitalist countries that continue to increase in life expectancy, don’t have these levels of stress or these depths of despair.

It’s more the blatant conspicuous glaring income inequality. But I think there is a lesson in there for all of us. I will say with regard to

expectations, I think the — one of the lessons that I think was learned as per society was that we always expect that our kids are going to maybe have

a better life than their parents. And that we’re going to leave the world better for them.

And what we realize now is the world changes. There’s no way probably this population, this white working class could have outperformed the

expectations of their parents, the greatest generation.

And I’m very careful now with my own children, Christiane, in terms of the language that I use, the expectations that I place on them, not

to create a level of stress that is toxic or expectations that are not achievable.

But we should all take time to de-stress because again, it’s not stress. It’s the constant stress that is the problem.

AMANPOUR: Yes. And you’ve spoken about meditation and mindfulness and ways that one can try no matter where you are in the world. So Sanjay,

it’s really, really interesting and well done. Thanks so much for talking to us about it.

GUPTA: It’s an honor.

AMANPOUR: And we continue to examine the correlation between inequality and stress right now as we turn to the generation that’s on track to suffer

from the worst income inequality in recent memory, and that’s millennials.

Our next guest says they view the state of their bank balance as an intellectual moral and personal failing. Like many in the gig economy,

Gaby Dunn wears several hats, comedian, activist, YouTuber, podcaster, and now author.

And her new book, “Bad with Money”, tackles the stigma surrounding personal finances. She told our Alicia Menendez that talking about money is now a

greater taboo than talking about sex was.

(BEGIN VIDEO TAPE)

ALICIA MENENDEZ, CONTRIBUTOR: Gaby, thank you so much for joining us.

GABY DUNN, AUTHOR, BAD WITH MONEY: Thank you for having me.

MENENDEZ: I loved the opening line of your book. It was, “Here’s the big secret About money, no one knows anything.” What do you mean?

DUNN: That’s what I learned. I mean, a lot of financial gurus will come at you with specifics as if they can predict the future, as if they know

exactly what each person should do, even though in my experience, everyone that I’ve talked to has individual extenuating circumstances.

And so it’s just not accounted for. You know, I think a lot of people were talking a big game and then the housing crisis happened. And I don’t think

a lot of people were giving protections or saying to people, hey, be a little wary of this because they just couldn’t predict it.

But then they go on and still talk about like money as if they are very confident. But they’re confident guessers.

MENENDEZ: If no one knows anything about money, what did you think you could add to the conversation?

DUNN: I wanted to be relatable rather than aspirational. And I wanted to make people feel like there’s no shame in talking about it and there’s no

stigma.

I always say, like, I’m lucky in that my family is not going to disown me for talking about it. My friends — you know, like my friends are going to

be OK. I’m still going to be alive. That’s my metric for talking about something shameful like I’ll still live, I’ll still have a home, I’ll still

have my dog. Everything will be OK.

So but for some people, that’s not the case. So I feel like if I can talk about something and I can be the person who can take on the embarrassment,

then I wanted to do that. And it’s helped a lot of people feel better about their own situations, even though they can’t personally talk about

it.

MENENDEZ: Let’s talk about that shame on your podcast, Bad with Money. You open going into a coffee shop with two questions. What were those two

questions?

DUNN: That was my favorite. It was, I went in and asked people, what’s your favorite sex position? Everyone was happy to answer it.

And then I said, OK, second question, how much money is in your bank account? Everyone was like, no. One girl answered but everyone was like,

“No, no, no, that’s personal, I can’t talk about that.”

MENENDEZ: And what did that tell you?

DUNN: That sex is cool and money is uncool. People are like — you know, I think there’s a lot of work in the sex positivity space and there still

needs to be more and I certainly do stuff there, too, on my YouTube channel.

But I realize that like my real secret was my money situation. And people would always come to me and say, wow, you’re so brave for talking about

your sexuality, you’re so brave for talking about sex positivity.

And I knew — like I felt a pit in my stomach and I knew in my heart that I was actually not brave because I was not talking about the real problem in

my life, the real thing that made me feel insecure and made me cry all the time which was money. So I felt like that was the last taboo.

MENENDEZ: Generally, where do you think that that shame and taboo around money come from?

DUNN: People see money as an intellectual, moral, and personal failing. They don’t see it as this ubiquitous thing that has to be in your life.

They see it as like this personal thing that says something about their self-worth and it says something about their intelligence.

And people judge. I mean people love to judge. Even people in worse financial situations will like laugh at and judge and give unsolicited

advice to people in, you know, a little bit lower situation.

As soon as I started the podcast, I got a ton of e-mails mostly from men being like, “Oh, here’s what I would do if I was you”, “Here’s how I would

be a billionaire if I was you.”

And I’ll be like, right, but like are you? Like, are you doing these studies? And they’d be like, “No, but here’s what you should do.”

MENENDEZ: I want you to read a part of the book for me, one of my favorite parts of the book.

DUNN: Sure.

MENENDEZ: Let’s see if I have what page it’s on, it’s about your bipolar diagnosis.

DUNN: Oh, yes, that was — that’s my favorite chapter. So this is what I wrote here.

When I was manic, I wanted to spend all my money because life was a breeze and who cared about social constructs like money? When I was

down, I desperately needed material things to make me feel better. No matter what state I was in, I convinced myself not to look at my finances

or try to sort out my bank accounts or plan for the future because it was too stressful and I was too fragile right now.

MENENDEZ: Why did you want to write about this?

DUNN: I felt like it would have been a disservice not to explain the eight years of bad decisions because I didn’t realize — you know I was

undiagnosed for a long time. So I didn’t realize that my mania or my depression was contributing to my finances, and I think a lot of people

don’t. I think a lot of people go undiagnosed.

So I would associate like sadness with needing to buy something. And then I would also, when I was manic, make all these plans and be like, I’m going

to go to grad school in Japan so I need to buy a book about Japanese culture. I never read that book. Like within two days, I would be like,

what? I don’t want to go to grad school in Japan.

And so I think — I thought it would help people to understand how mental health contributes to finances. And maybe once they know that, they can

step back and take a look at what they need to do.

In that situation, I talked to a bipolar expert named Julie Fast who gives advice about freezing your credit cards when you feel manic, or only

dealing in cash, or, you know, having a buddy who can say, “Hey, you’re being kind of manic. Like are you sure you want to spend this money?” I

just felt like it would have left out a huge part of my story if I didn’t mention what was contributing.

MENENDEZ: You write about how much of our attitudes about money come from our family and from the money script that we grew up with. What was yours?

DUNN: My parents were big spenders and big into experiences. My dad was an addict and an alcoholic growing up. So my mom talks about how she would

not understand where money was disappearing to.

She was a divorce and child custody attorney. And so she would make some money and was more of the breadwinner. My dad worked in construction. She

would be confused as to where the money was going.

And she admits she was pretty naive about it. And then they also, like, just didn’t want to say no to things. So like my mom would, you know, I

say in the book my mom would do a lot of her work for free.

And I asked her about it. And then she said, “Well, there were children who needed my help.” And I said, yes, there were children who needed your

help living in your home as well.

They talk about how they didn’t really think ahead about a lot of things. They don’t have a retirement. They spent $20,000 on my Bat Mitzvah, which

is like mind-blowing.

So they just wanted things — but it would be feast or famine and I had a lot of whiplash where they would say, you know, today they would buy a

bunch of stuff and then tomorrow, they would be like, “We’re poor.”

And I, as a kid, was like, which is it? So I would get some money for something I would be working on and then I would immediately spend it in

this way of, like, oh, well, I don’t know, I could die tomorrow and I don’t know, you know, when — like I just can’t have it. I can’t have it in my

possession.

MENENDEZ: And so how do you break that cycle?

DUNN: Just knowing about it. Like sitting down and writing out what you learned from your family, and then writing out if it serves you anymore if

it’s something good.

One of my friends, their parents were accountants or their parents opened bank accounts for them when they were 15, so like interest compounded.

Depending on your family, like a lot of my friends had really good situations.

Then I talked to some people, like a lot of young people in Gen Z who their parents are Millennials or Gen X. And they are terrified because their

parents are dodging calls from Sallie Mae or have a bunch of student loans.

And so they’re learning like maybe I shouldn’t go to an expensive college, maybe I shouldn’t take out student loans because their anxiety about money

like seeps into the whole household.

MENENDEZ: U.S. student loan debt reached nearly $1.5 trillion last year. Where do you place that in this larger societal conversation About money?

DUNN: I think it causes almost no economic mobility, which is true right now in America. And it keeps people in the class that they’re in.

So even though people want to get a better education, this American dream of getting this nice education and then going off into the workforce with

like a great degree, they’re not finding that they can get jobs based on that, and then they’re in $40,000, $80,000 of debt. So they’re starting

out their financial life in a deficit.

But I see a lot of younger people opting for community college or — which is a great resource. Or opting to maybe not even go to school based on

what they want to do. Like a young girl, I spoke to, wants to be a photographer. So she was like, “I could get a job at a wedding photography

place and buildup my Instagram. And I wouldn’t have to spend money on college.”

MENENDEZ: What is the millennial myth?

DUNN: The millennial myth is this idea that the Millennial generation is a monolith. I mean I think the depiction we see most often is like a white

upper-middle-class person holding an iPhone, taking a selfie, eating avocado toast at their start-up job. And like maybe that start-up

doesn’t have health insurance.

And that is so not the entire Millennial generation. Like there is this thing where Millennial — a generation is seen as the rich people in that

generation and it’s not — and then poor people are just poor.

So, for instance, like a 25-year-old Latin X, like mother of two working a minimum wage job in East Texas, that’s a Millennial. But nobody would put

that Millennial on a Time Magazine cover, for instance. Millennials are working hospitality, retail, and service industry more often than not.

That makes the minimum wage a Millennial issue.

Like there are these things that we only talk about student loans as a Millennial issue, which they are. But there is — there are other

Millennials out there who have different concerns. And so when we only talk about one type of Millennial, it has a trickle down to policy and so

we’re ignoring one group.

MENENDEZ: You use these stats in your book, 2016 Pew Research found that 25 percent of Americans made money on a digital earning platform like

Airbnb or Lyft. Thirty-seven percent said it filled gaps in their employment. So on, so forth.

In your experience, what is the reality of being a part of that gig economy?

DUNN: There is a statistic that shows — that I found in the book that in the past, like in the ’90s and ’80s, if you were doing a side hustle or

something in the gig economy, you were saving up for something, a trip or some gift or special thing.

Now, the people that are in the gig economy are using it as their main income. So that’s huge. I mean, that makes most people freelancers. More

than half of young people will be freelancers by 2020.

So that’s like people cobbling together an income whereas like they don’t have the steady income and the pension and stuff of the past. And in my

experience, I do — I still do a lot of freelance type stuff.

I mean I work as a writer. So like if I’m in a writer’s room, that’s a short time. That’s not a job that I would have for more than three months.

Selling merch or doing — really, or doing — like I do like platforms where you can like make videos for fans for a certain amount every video.

So like I’m even cobbling together an income from multiple places.

MENENDEZ: Right. I mean you have a large social media presence. And at the same time, there have been moments in your life when you’re like trying

to find quarters in your car so that you can pay for things.

DUNN: That was what kicked off the podcast, was I had some branded Deals that came through, and they’re not a lot of money at the time and they’re

still kind of not. And so I would split that with my comedy partner. Not everyone has a partner on their YouTube channel so they would make the

whole money, but I would make half.

And then it would be like comments because of the brand deals and because people didn’t understand social media, they would say, oh, you’re a rich

girl now. I wanted to defend myself on every comment but I couldn’t.

And so I asked some questions. Like even — they had no idea. Like I wrote back to one girl and said, how do you think I’m making money? She

said YouTube pays you a salary. Every week, YouTube pays you a salary for your videos.

And I was like, what? Do you think I’m an employee of YouTube? I make pennies on each ad.

MENENDEZ: I think one of the challenges of these platforms is the monetization component. But then the other part is that it can be femoral.

I mean Vine was a thing.

DUNN: Gone.

MENENDEZ: Now, it’s gone.

DUNN: I like to tell young people when they say, “I want to be a YouTuber” or “I want to be an Instagram influencer.” I would go, no, you want to be

a photographer or you want to be a model or you want to be a video editor or you want to be a producer or a director. That’s what you have to say

because those platforms are not going to be there.

So YouTuber, not a job. Like Instagram influencer, not a job. You need to say that you are a job that you could do anywhere. And a lot of them don’t

realize that until I say that.

MENENDEZ: I’m sure there is someone who is watching who says, this person says, no one knows anything about money. She’s bad with money herself.

DUNN: Yes.

MENENDEZ: She’s a YouTuber and podcaster. Why am I listening to her? Tell me about how to be good with money.

DUNN: I think you want someone who is in the trenches who relates to you, who understands, like, that the reality of life, like the realities that

come up. Of course, like, you have a savings and then there’s a car breaking down and you’re like, oh. Or like a girl came to me and said,

should I — I’m making money now, should I start a savings account or should I go to therapy?

And me as someone who has had mental health breakdowns, who has spent all their money in a mental health break down, I mean that’s something that I

can answer from experience. You know, I took a year, I researched this book.

So I like to say that I’ve cut a year off of what you need to do to learn. Read the book. You have won a year of your life.

MENENDEZ: Gaby, thank you so much.

DUNN: Thank you for having me.

(END VIDEO TAPE)

AMANPOUR: Gaby Dunn is certainly relatable with all that advice there.

That’s it for our program tonight.

Thanks for watching Amanpour and Company on PBS and join us again tomorrow.

END