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Brain Capital and Brain Healthy Cities
LF06 | 'Brain Capital' places citizens' mental health and wellness at the heart of the economy. A "Brain Healthy Melbourne" could be the first to try it.
The brain is individually, and collectively, our most important asset
Pop quiz: What is the link between fake news, the gut biome, rewilding, maternal health and libraries? Answer: they’re all factors impacting ‘brain capital’, a new term for the economic asset that comprises a population’s collective brain skills and brain health. Brain capital is how we’ll sink or swim in the new ‘brain economy’ in which we’re all now operating.
No prizes for guessing that this week is all about the brain and in particular the intersection between brain health, economics and places. This column was inspired by a meeting a few days ago in Melbourne and Zoom hosted by Looking Forward and Fordcastle. The topic was Brain Healthy Cities, and the guiding question was, what would it take to make Melbourne a Brain Healthy City? And before we get there, what actually is a brain healthy city?
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We’re all living in a brain economy
In a 2021 article in Nature, Harris Eyre MD PhD and others describe a brain economy as, “one where most new jobs demand cognitive, emotional, and social, not manual, skills, and where innovation is a tangible “deliverable” of employee productivity.” It continues, “with increased automation, our global economy increasingly places a premium on cerebral, brain-based skills that make us human, such as self-control, emotional intelligence, creativity, compassion, altruism, systems thinking, collective intelligence, and cognitive flexibility. Investments in brain health and brain skills are critical for post-COVID economic renewal, reimagination, and long-term economic resilience.”
Bringing brain health mainstream
Brain health is a broader term than mental health, which for too long has been an underreported and stigmatized topic. Unlike more obvious, physical maladies, mental health issues can trigger judgment rather than compassion. Nearly half of those living in USA, Australia and UK will experience mental issues at some point in their lives, and over half of those with a mental illness don’t access treatment options. Globally, over 300 million people worldwide are affected by depression, 250 million by clinical anxiety (a 15% increase over the past 10 years) and 60 million by bipolar affective disorder. The number of people living with dementia is set to grow to more than 150m by 2050.
Whereas mental health generally has a deficit assumption, brain health is more upbeat, something to be optimised, not avoided. This is a fast-moving, hard-to-pin-down topic but for the purposes of this post think of brain health as i) holistic - integrated health of mind and body ii) neutral - brain optimisation not just about deficits and disease and iii) measured through the life course - not just about older people.
Our brain health is impacted by a diversity of variety of factors ranging from air pollution, eco grief, depression and anxiety, and access to nature (see e.g. biophilic cities) through early childhood development, lifelong learning and nutrition. Libraries are to brain health what long walks are to physical health. Sociologist Eric Kleinenberg cites libraries as a valuable part of our ‘social infrastructure’ - our built environment that promotes or impedes social connection and as such impacts the health as well as mental health of the community. Libraries could be considered as Web 0.5; freely available information but the communication and community stay physically situated, not global. Andrew Carnegie built over 2500 of them as sources of knowledge and tools for self-improvement.
Brain Healthy Cities | Kickoff event, Dec 12, 2022
In Melbourne and on Zoom this week, 25 people gathered to explore the topic of brain capital, its link with brain health and relevance to Melbourne.
We had presentations from Kelly O’Brien, Omar Ibrahim, Iain Butterworth, Mandy Salomon, and Harris Eyre, and will share some key points from each below. This topic is more elephantine than most; everybody engages with it in a different way and sees different implications.
The event came about from a conversation I had with Harris in San Francisco a couple of months ago. We would both be in Melbourne at the same time and wanted to bring others in to help discuss the broad and fascinating topic of brain health and its application to city design and innovation ecosystems. Harris is a psychiatrist, academic, tech entrepreneur and author, and has been championing the emerging concept of brain capital for the past two years, explicitly aiming at economic policy makers. Reframing brain health and mental health from “just” a health condition to a driver of our most valuable economic asset, brain capital, is apparently generating interest from policy makers searching for visionary Big Ideas and struggling to escape post Covid recession.
Kelly O’Brien is accelerating private sector collaboration
Kelly O’Brien combines her Savannah, Georgia charm with a laser focus on a mission to put an end to dementia. The US non-profit she works for, USAgainstAlzheimer’s was established in 2010 to “conquer Alzheimer’s” and has a three-part strategy: prevention and risk reduction, early detection and diagnosis and equitable access to treatment.
She leads their Brain Health initiative, and recently has been focused on promoting healthy aging and reducing risk factors for dementia. Her work is guided by the Lancet’s 2021 framework of 12 identified risk factors that can prevent or delay up to 40% of dementias.
There are so many aspects of brain health, the most important thing we’re doing here is connecting the dots
Interestingly, hearing loss is one of the biggest drivers. Kelly shared some of her ecosystem building initiatives, such as proving policy input to the Federal National Plan to End Alzheimers, a new Alzheimer’s Index that confirms the impact of low education, hypertension, obesity and diabetes on prevalence of the disease, a Brain Health Academy, which provides free education for healthcare professions and a brand new initiative ‘Action for Healthy Aging’, which is building a private sector collaborative to achieve the new U.S. Goal to “promote healthy aging and reduce the risk factors for dementia, and has a focus on place. Kelly pithily summarised the need in this area, and the ambition of the group, as ‘connecting the dots’.
Note: Kelly’s presentation is here.
Omar Ibrahim is using AI and brain science for good
Omar Ibrahim is a dot connector. He embodies the kind of multi-disciplinary background that makes him a systems innovator in the brain capital space. After his degree he spent time in working on smart cities in China and for a UN-funded project, in startups, academia and then did a Phd on using genetics and machine learning to predict the clinical outcomes of patients with concussion. He took that experience to Monash University, predicting the evolution of multiple sclerosis in patients based on genetic tests. He now works with the famed mental-health focused Black Dog Institute, looking at ‘digital phenotyping’ - how usage patterns of mobile phones connects with brain health,
Unlike in dystopian futures, there’s plenty of good things to come out of AI and brain science
Omar shared an upbeat narrative about AI and brains - rather than the dystopian scenarios of AI replacing jobs and rendering humans a sub-par species, Omar’s experience is leveraging AI to more effectively predict the paths of disease and make it easier to manage and treat. His latest explorations are looking at the intersection of regenerative (or doughnut) economics and brain health.
Note: Omar’s presentation is here.
Iain Butterworth is passionate about liveable cities - and suburbs
Iain Butterworth, who met Harris as a fellow Fulbright Scholar, has spent years understanding what makes healthy places, coming at it from a ‘community psychology’ lens, where the focus is on health and the influence of community and environmental factors, rather than a more individualistic, deficit-based model. Iain has long been involved in liveability, which he defines as being about “equal access to the things that make life easy and life good”. He helped developed RMIT’s Liveability Indicators which explore liveability across seven policy domains: employment, food, housing, transport, social infrastructure (arts, access to education, sports and recreation), public open space & walkable communities. According to Iain, each of these components can have a mental health component, but what that is, how it’s measured and how its influenced remains a topic worth exploring.
In the suburbs, cheap housing doesn’t mean cheap living - as there is a lack of local services, requiring multiple cars and long commutes. The first social infrastructure in suburbs is often McDonalds, drinking and betting shops.
Iain shared some perspectives of the Economist Intelligence Unit’s Global Liveability Index. Until recently this was Melbourne’s favourite index - as it scored #1 globally for an unprecedented seven years in a row. However, this Index does not look at the experience of people living locally, instead taking a ‘whole-of-city’ geographical lens which overlooks local variations between neighbourhoods. He noted that “it tends to focus on the life experiences of expat executives, rather than local residents”. For example, housing affordability is typically not counted in the metrics. The RMIT
Iain was particularly critical of Melbourne’s sprawling suburbs, “in which housing is affordable, but living isn’t”. In other words, the lack of social infrastructure and local services mean families need two or three cars, spend hours commuting and significant sums on petrol, and live an unhealthy lifestyle. This is the result of “upstream” urban planning decisions such as installing (or not installing) good public transport services and bike lanes - things that impact behaviors “downstream”. Iain noted that the first piece of “social infrastructure” that are built in Melbourne’s urban fringes are often McDonald's, liquor stores and betting shops. Rather far from the laudable vision of the 20 minute city, which may exist in more central areas, but hasn’t yet been materialised where they’re needed most. Iain and other liveability specialists have long been advocating that planning legislation needs to make the timely provision of liveable places a planning requirement, rather than an opt-in for developers.
Note: Iain’s presentation is here.
Mandy Salomon delivers digital engagement for dementia ‘dyads’
Mandy Salomon, then shared perspective as a startup. She spends time between San Francisco and Melbourne running Mentia. The company is building a virtual world, accessible via tablets that provide “precision response to individuals living with dementia”, helping them engage and express their needs and wishes. Mentia is a science-based initiative based on Mandy’s PhD thesis. The product, DevaWorld is a virtual world that can be shared between the person with dementia and their caregiver. The tablet model is increasingly ubiquitous and allows for greater interactivity than current VR models. Mandy noted how rich and dynamic the technology space was in this area.
Mentia is based on a number of foundational assumptions. First, there’s a need for more multilingual, visually-based learning for caregiving, as we’ll be relying more heavily on immigrant caregivers with limited language skills. Second, is about improving communication in the dyad - between the caregivers and individual with dementia. Third, it’s about empowering older adults and changing the perception of older people - giving them agency and voice.
“When you carry real pain and real joy simultaneously, this is maturity and growth.” - Brad Pitt
The zeitgeist has evolved. Innovative models used to be about thinking that people with dementia can live optimally beyond their disease, as long as they have supportive care of others. A dementia advocate, Christine Bryden describes dementia as “One’s own unique coping mechanism in the face of utter devastation”. Mandy called on all of us to recognise the resilience and learning opportunities we get from those living with dementia. Finally, she called for greater intergenerational engagement and new living and working models.
Note: Mandy’s presentation is here.
Harris Eyre is making Brain Capital a new asset class and policy priority
Harris Eyre shared his vision of brain capital as an intersectional device targeted at policy makers who would get lured in by the intersection of two hot topics, brain science and capital. In the couple of years since he’s been advocating for it, he’ s seen a rapid growth in adoption of the term, not least by the WHO, who this year noted that “investing in building brain capital is fundamental to meeting our modern societal challenges, and to drive innovation” - WHO 2022. Harris shared a number of frameworks and emerging concepts that connect brain health with place and economics, such as environmental neuroscience and neurourbanism.
He noted that the Global Brain Health Institute was funding research in this area, and one of their fellows, Greg Walsh had developed the idea of “cognitive load of an environment”. Over stimulating, loud and stressful environments can deter people from leaving their house, while inside bright shiny floor tiles could be seen by someone with dementia as an ocean, and a black rug seen as a hole to fall into, creating unnecessary stress and escalating isolation and loneliness.
‘Green Brain Capital’ asks how do we change the brain infrastructure of a country to be more sustainably focused
Harris’ shared the idea of ‘Green Brain Capital’, which he had recently presented in Egypt at COP27. This concept is aimed at changing the ‘brain infrastructure’ of a country to be more sustainability focused? This requires a number of elements to be in place - brain health, ecological intelligence, creative infrastructure, green skills and digital literacy. The goal worth fighting for, Harris pointed out, was the chance to create a “positive tipping point”; the opposite of the negative tipping points we’re currently experiencing when negative outcomes create more negative outcomes (such as melting white ice turning into dark blue water which then absorbs more warming radiation). When enough people demand a better path forward there’s a chance we may tip into a better model for all.
Note: Harris’ presentation is here.
Going forward, there was a community and hunger to learn from each other. A few of the specific ideas shared were:
Regular meetings, hearing from experts and innovators and building a community
A communication platform to continue the conversation and open it up broader (e.g. Slack, Discord)
A taxonomy of topics and sub-topic to be covered to reflect the broad range of issues under discussion
A systems map of individuals and organisations working in this space
A DAO to build a decentralised community and attract funding to vetted projects, sourced and managed by a decentralised community of experts.
A small pilot project to identify practical steps and focus on a handful of measurable outcomes, which could be used in turn to develop a ‘blueprint’. One such idea would be to do this in Melbourne...
Melbourne - the first brain healthy city?
Melbourne is a natural candidate to be a brain healthy city. Having been knocked off its ‘most liveable city’ perch in recent years, the smart burghers are coming up with Bold New Ideas, and what more appropriate to the Education State than a recognition of the economic and societal value of the brain? This would come with a targeted strategy to optimize brain skills and brain health throughout the lifecourse, and ideally help reinvigorate the city center and economic activity, still recovering from a particularly stringent Covid lockdown.
Perennial competitor Sydney is known for beaches, beauty and glitz, while Melbourne feels more at home with its Writers Festival and coffee culture; more Freud’s Vienna than Kim’s LA. It punches above its weight in academics, with Melbourne University, RMIT, Swinburne, Monash, Deakin, La Trobe as well as Dementia Australia, Howard Florey Institute and others.It has a thriving biotech scene, and serious new commitments around entrepreneurial support, targeting scaleups not just startups.
A sub-group of this new community will start to explore ways to make this exciting but rather high level conversation grounded in the reality of what can be achieved. If you’d like to be involved in developing a plan for Melbourne, or any of the follow up actions above, get in touch at firstname.lastname@example.org.
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