What We Learned at the United Nations Science Summit on Brain Capital
About 1 in 4 firms have announced targeted solutions to the United Nations’ Sustainable Development Goals. Brain Capital is not only a means to take that progress further, but to see progress through a more holistic lens. According to the Brain Capital Alliance, Brain Capital “considers mental health and brain skills . . . as indispensable parts of the knowledge economy.” At Steelcase’ sprawling location abutting Columbus Circle in New York City, a diverse group of neuroscientists, entrepreneurs, policymakers, and other stakeholders from around the world gathered recently to discuss how Brain Capital can tackle society’s most pressing challenges, from behavioral health to burgeoning knowledge economies.
Countless rich questions highlighted the day-long symposium, which became a sort of Brain Capital “stress test.” But as we at HKS continue to look for ways that design can help shape and guide the future of our communities, here are five thoughts from the summit to help all of us think about how to achieve that.
Why the focus on “capital”?
Mental health disorders are projected to cost the global economy $16 trillion by 2030, according to Pawel Swieboda, who delivered an opening address. From Brain Healthy workplaces to reinvesting in behavioral health facilities or drug-treatment facilities, the financial upside for cities is clear. But value itself also needs rethinking. Clayton Mitchell pointed out that if we use traditional measures, like ROI, on everything we do, we’ll end up in the present situation.
Rym Ayadi said that capital accumulates and deteriorates driven by several factors — political, social, natural, and economic contingencies. Many panelists noted that a new global economy is possible, with Brain Capital as the fulcrum of future prosperity. Our economy is a brain economy. With the rise of automation, the skills in demand will rely more on cognitive, social, and emotional capacity.
Taking this idea one step further, Tom Osha of Wexford observed that innovation districts may be the anchors of future cities, buoyed by university research centers, clinical enterprise, and community inclusion.
What do we do about youth well-being?
Across the globe, Gen Z reports a higher share of mental health challenges than any other generational cohort, and if Brain Capital is to inform curriculum redesigns or community interventions, their voices can’t be overlooked. The morning program of the Brain Capital symposium was devoted to youth and adolescent mental health, as 1 out of 4 Generation Z people to report their mental health as fair or poor, according to the American Psychological Association. Youths today pursue health information differently than previous generations — through web-based tools, mobile applications, and online health information — and it’s the responsibility of health providers, and community stakeholders, to meet them in these spaces.
What can the built environment do about brain capital?
Marta Schantz argued that we need to take a closer look at the places we inhabit through the lens of real estate portfolios. “Greening” our real estate is a matter of growing the bottom line, and the capital trend toward “cognitively-healthy” properties is real. Investors are paying more for green buildings, and occupants are seeing them in both residential and commercial spaces.
People spend 90% of their time indoors. So why wouldn’t they have the expectation that both commercial and residential spaces promote healthier people? One study finds that workers within green-certified buildings report 30% fewer sick days than baseline.
Ultimately, the environment either promotes or impedes a continuum of care. Electrification may alleviate asthmatic symptoms indoors, and environments may proactively help neurodiverse persons or those experiencing neurodegenerative disorders. If we design for people who are most sensitive, we all benefit. Design ideals, including biophilia, access to natural light, and access to both quietude and community, stand to benefit all people. Novelty and fascination aren’t just design features, they’re critical to brain-healthy individuals by boosting creativity and alleviating cognitive fatigue. Jennifer Kolstad may have said it best, “beauty isn’t gratuitous, it’s essential to our well-being.”
How do technology and Brain Capital work together?
Steelcase’ Columbus Circle location embodies what a brain-healthy and technology-enabled space can be. Outside the main stage, meeting rooms and collaboration areas were set up around several floors where event participants could hold a meeting or take a respite from the crowd. Beautiful variations of focus spaces were ubiquitous on every floor. Each room was enabled with a screen to view the main stage. A balcony looked out over Central Park.
Technology may be a supplement to the work we must accomplish each day — but it is also the technologies that permeate a continuum of care.
The Agency for Healthcare Research and Quality reports that there are more than 350,000 health care apps on the global market today. With all that choice, the consumer is stretched to find what works. Entrepreneurship is necessary to fulfilling the goals of Brain Capital, but we need to keep an eye on “technologies that produce solutions in search of a problem.”
One of the best discussions on the evolving landscape of technology came with the final keynote by David Faigman, the Dean and Chancellor of UC Law College of San Francisco. Throughout history, industrialization has led to evolving standards of law. With radio and the television, the FCC was formed. Product liability law evolved under the new relationships between tools and users. Innovation goes hand-in-hand with the evolution of law. And product developers, operating alongside lawyers, can both protect communities while working toward innovative products.
What are the realities of today’s health care climate?
Pennsylvania State Rep. Aaron Kaufer, a Democrat, said “we’ve spent so much time destigmatizing talking about drug and alcoholic abuse, we need to spend just as much time with what to do next.” Today, the out-of-pocket expenses for mental health are climbing, especially after many states began to roll back funding for telehealth. But it’s not only about throwing money at the problem, but innovating appropriately. Published in the New England Journal of Medicine, the famous Oregon study demonstrated that expanding a tenet of the safety net, like Medicaid, can only get us so far in more favorable health outcomes.
Jane Brown focused her words on the practical questions that need answering. What are covered benefits or fee schedules? How do reimbursements mix with quality of care delivered? We’re working through a model that has long since stopped working. What is the real cost of care? Will the expansion of telehealth improve outcomes or simply reduce costs? Medicaid programs cover more telehealth programs than ever. The financial structures are problematic, however. It’s a policy issue that telehealth appointments pay less, and are chronically underfunded, because reimbursements aren’t as high as in-person visits.
Finally, if perfectly rational actors don’t fit our economic models, it won’t for the concept of Brain Capital either. Ideally, every resident would exercise, have great nutrition, and do everything possible to receive preventative care. This ideal is far from the current benchmark, where food deserts exist, population health differs considerably by zip code, and those on Medicaid receive 50% of their care through the emergency department of a health facility. People aren’t perfect, but neither are the environments built for them — and there’s much to be improved in either capacity.
A full event recap report can be found here. This event was organized jointly by the Brain Capital Alliance, Rice University’s Baker Institute for Public Policy, HKS and CADRE, with the support of the Mental Health Services Oversight and Accountability Commission of California as well as Kooth.