Four For Friday | Sept 6, 2024

LF138 | Fewer bats resulted in more infant deaths, a Harvard plan to fix aging in the UK, the social microbiome, valuing community + Deloitte's AI report

Welcome to Looking Forward’s Four For Friday. Four things that have piqued my interest this week, together with a bonus: AI Tip of The Week. Enjoy!

Over 1000 American babies died due to a bat disease

One challenge with complexity is attribution - how do you know that a butterfly flapping its wings in Brazil really did lead to that tsunami in Japan? This fascinating research reported in the NYT looked at places where a new fungal bat disease - ‘white nose syndrome’ took hold across 245 counties in the US from 2006 to 2017.

These places saw an increase in insects, and in turn farmers used 31% more pesticide to protect their crops. That caused an infant mortality increase of 8% - a shocking 1334 childhood deaths - over that time.

The same researcher found that a die off of vultures in India caused half a million more deaths due to rotting animal corpses (the preferred vulture snack) polluting the water supply.

So What? These stories provide a tangible way to see the short term impact of the climate crisis, unsettling the fragile ecosystems that we take for granted.

Systemic improvement of society in UK

Social care in the UK is a hot potato that gets unceremeniously tossed from government to government while people are dying on waiting lists for care, families are struggling and local councils (who are generally on the hook) are increasingly going bankrupt.

A call for a bold systematic change for the aging society in the UK timed for the incoming Labour government, with a piece in the FT referencing a new Harvard paper that makes the case for a new long-term care insurance system as part of a systematic approach.

One area that is ripe of innovation is ‘bed blocking’ when people stay in expensive, acute hospitals because they can’t safely go back into the community (the first point below). The paper includes a systems map that identifies where the blocks happen, showing that only 12% of bed disccharges from hospital happen on time:

There are six areas of policy recommendations, all of which are ripe for innovation:

• NHS/social care interface. Ensuring a more integrated approach between health and social care (sound familiar?), particularly looking at five transitions of care: falls/fractures, unnecessary hospital admissions, deconditioning in hospital, delayed discharge, and ineffective intermediate care.

• Data and technology. Better use of tech and data, in particular in social care, which has long been overlooked, and integration with health system data.

• Workforce. Exploring solutions to the caregiving crisis such as delegating healthcare tasks to care workers and professionalizing the workforce to improve stability.

• Commissioning and regulation. Helping the new Integrated Care Systems (ICSs) to create person-centred services and “focus on giving individuals a fulfilling life, not simply managing decline”

• User empowerment. Looking at ways to improve choice and agency of older people and families in this ‘quasi market’ using e.g. personal budgets.

• Funding: Exploring new funding models for social care, drawing on examples of national universal systems such as in Germany and Japan.

So What? A good systems analysis that shows that no-one solution - new tech or more funding - is going to be a magic bullet. To have a chance, this needs both political leadership and public buy-in.

In search of the social microbiome

There’s more recognition of the important role played by the gut biome in overall health; this new research suggests that the gut biome itself is influenced by the people you spend time with. The hypothesis is that the sharing of certain phenotypic traits such as obesity or disease resistance among family and friends could be as a result of shared gut microbes.

“The social microbiome is the collective sum of the microbiomes within an interacting group of organisms: family, classmates, or friends”

So What? We’re only just getting started with understanding the importanct influence of the gut microbiome on population health.

The value of good communities on house prices

This report from 2018 is worth highlighting for the connections it made between features of a home purchase that are valued by prospective residents. It describes a concept of ‘social value’ that is the willingness to pay for a home with these features, compared to a similar home without them.

It breaks them into three categories: house, place and community and finds that being close to green space and ‘being able to borrow from neighbours’ were at least as valued as larger homes or more efficient energy features.

So What? More evidence of the importance of place making and community, this time with numbers attached.

Bonus - AI Report of the Week

Q3 report by Deloitte about AI in the enterprise. Two areas of focus: data foundations and governance, risk, and compliance.

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That’s all for this week. As always, feedback welcome. Feel free to share insights or links of interest.

- Stephen