Sharp Brains: Brain Fitness and Cognitive Health News

Neuroplasticity, Brain Fitness and Cognitive Health News

Icon

10 Highlights from the 2007 Aspen Health Forum

AspenThe Aspen Health Forum gath­ered an impres­sive group of around 250 peo­ple to dis­cuss the most press­ing issues in Health and Med­ical Sci­ence (check out the Pro­gram and the Speak­ers bios), on Octo­ber 3–6th. It was the first con­fer­ence, by the way, where I have heard a speak­er say: “I resus­ci­tat­ed a woman yes­ter­day”.

Key high­lights and trends:

1- Glob­al health prob­lems require the atten­tion of the sci­en­tif­ic com­mu­ni­ty. Richard Klaus­ner encour­aged the sci­en­tif­ic com­mu­ni­ty to focus on Glob­al Prob­lems: mater­nal mor­tal­i­ty rates, HIV/ AIDS, nutri­tion, can­cer, clean water.  Bill Frist, for­mer Sen­ate Major­i­ty Leader, added to that list the increas­ing epi­dem­ic risks of glob­al zoot­ic dis­eases (trans­mit­ted between humans and ani­mals), sup­port­ed by 2 inter­est­ing data points: at any one moment, there are 500,000 peo­ple fly­ing world­wide; in a year, air­lines trans­port the equiv­a­lent of 2 bil­lion pas­sen­gers.

2- “Let’s get real…Ideology kills”. Mary Robin­son, for­mer Pres­i­dent of Ire­land, on what it takes to stop HIV/ AIDS: “I am from Ire­land, a Catholic coun­try. And I am Catholic. But I can see how ide­ol­o­gy kills..we need more empa­thy with real­i­ty, and to work with local women in those coun­tries who need things like female con­doms.” She was implic­it­ly crit­i­ciz­ing the large bud­get devot­ed to unre­al­is­tic absti­nence pro­grams. This ses­sion includ­ed a fas­ci­nat­ing exchange where Bill Frist rose from the audi­ence to defend the role of US aid, explain­ing how 60% of retro­vi­ral drugs in African coun­tries have been fund­ed by the Amer­i­can tax­pay­er, high­light­ing Pres­i­dent Bush’s courage to make HIV/AIDS a top agen­da item in many devel­op­ing coun­tries, and crit­i­ciz­ing oth­er coun­tries for not doing enough. Which made Nobel Prize Lau­re­ate Peter Agre, also in the audi­ence, stand up and encour­age the US to real­ly step up to the plate and devote 1% of the GDP to aid, as a num­ber of Euro­pean coun­tries do, instead of 0.1%.

3- Where is the new “Sput­nik”?: Basic sci­ence is cru­cial for inno­va­tion and for eco­nom­ic growth, but it is often under­ap­pre­ci­at­ed. Sci­en­tists are not “nerds”, as some­times they are por­trayed in pop­u­lar cul­ture, but peo­ple with a deep curios­i­ty and dri­ve to solve a Big prob­lem. Many of the speak­ers had been inspired by the Sput­nik and the Apol­lo mis­sions to become sci­en­tists, at a time when the pro­fes­sion was con­sid­ered cool. Two Nobel Prize Lau­re­ates (Peter Agre, Michael Bish­op), talked about their lives and careers try­ing to demys­ti­fy what it takes to be a sci­en­tist and to win a Nobel Prize. Both are grate­ful to the tax­pay­ers dol­lars that fund­ed their research, and insist we must do a bet­ter job at explain­ing the Sputniksci­en­tif­ic process to soci­ety at large. Both are proud of hav­ing attend­ed small lib­er­al arts col­leges, and hav­ing evolved from there, fueled by their great curios­i­ty and unpre­dictable, serendip­i­tous paths, into launch­ing new sci­en­tif­ic and med­ical fields.  Bish­op list­ed a num­ber of times where he made deci­sions that were con­sid­ered “career sui­cide” by men­tors and col­leagues, and men­tioned “I was con­fused” around 15 times in 15 minutes…down to earth and inspir­ing.

4- We need a true Health Care Cul­ture: Mark Ganz sum­ma­rized it best by explain­ing how his health provider group improved care when they rede­fined them­selves from “we are 7,000 employ­ees” to “we are a 3 mil­lion strong com­mu­ni­ty”, mov­ing from being a cost con­troller with a pater­nal­is­tic atti­tude to a health facil­i­ta­tor, look­ing under­neath symp­toms to iden­ti­fy and deal with under­ly­ing pat­terns. Mark also announced the launch of the Aspen Health Stew­ard­ship Project to 1) iden­ti­fy levers to change the cul­ture of con­trol, 2) frame the upcom­ing polit­i­cal health care debate, 3) cre­ate a report­card to screen all polit­i­cal pro­pos­als. Will be inter­est­ing to check the progress of the ini­tia­tive in next year’s con­fer­ence.

Relat­ed to this, there were pan­els on how to improve Med­ical Edu­ca­tion, includ­ing train­ing doc­tors to be mem­bers of a team and improve patient-based prob­lem solv­ing and “soft skills” such as how to apol­o­gize to patients and their fam­i­lies. And on Elec­tron­ic Med­ical Records, that have proven to reduce med­ical mis­takes and over­all health­care sys­tem costs, yet many physi­cians resist their use due to the time required to fill out the online forms and work­flow changes required. An inter­est­ing data point: in 65% of vis­its to the doc­tor these days, patients bring some­thing print­ed from the inter­net.

5- You can’t man­age what you can’t mea­sure. We heard many times how defin­ing and mea­sur­ing out­comes, so com­mon in the pri­vate sec­tor, is crit­i­cal to ensur­ing a good allo­ca­tion of resources in the health and sci­en­tif­ic fields, that use so much tax­pay­er mon­ey. For exam­ple. NIH fund­ing grew from $9B in 1994 to $29B in 2007, yet the results are not clear. The same hap­pened with health care as a whole, a sec­tor that now con­sumes 16% of the US GDP with health out­comes (infant mor­tal­i­ty, patient deaths in hos­pi­tals) worse than oth­er coun­tries that invest far less. There is an appar­ent con­sen­sus that sci­ence and health­care need more resources but will only get them once they clean house.

6- The ris­ing role of pub­lic-pri­vate part­ner­ships: There are mul­ti­ple ini­tia­tives launched to bridge the increas­ing gap between acad­e­mia and indus­try. The Foun­da­tion for the NIH has facil­i­tat­ed key con­ver­sa­tion between the FDA and phar­ma com­pa­nies. The Gates and Clin­ton Foun­da­tions have launched inno­v­a­tive part­ner­ship mod­els to tack­le glob­al health prob­lems. The Myelin Repair Foun­da­tion was launched to build bridges once its founder, who had “assumed some­one had a plan”, dis­cov­ered that lit­tle progress had hap­pened in 20 years to help patients with mul­ti­ple scle­ro­sis.

7- From Lifes­pan to Health-span. Pop­u­la­tion dis­tri­b­u­tion in devel­oped coun­tries is shift­ing from a “pop­u­la­tion pypupulation pyramidramid” to a “pop­u­la­tion rec­tan­gle” (see Japan pop­u­la­tion “pyra­mid”, right). There was a good deal of empha­sis on the biol­o­gy of aging and healthy aging, both on how the envi­ron­ment can reg­u­late gene acti­va­tion and on genet­ics. Cyn­thia Keny­on, a UCSF researcher showed her research on how dis­abling one spe­cif­ic gene in a worm can dou­ble that wor­m’s lifes­pan, and men­tioned how that study has been repli­cat­ed with fruit flies and mice, and could, con­cep­tu­al­ly, help humans live longer & health­i­er lives. The point of much ongo­ing research is not “how to spend more time on the nurs­ing home” but how to slow down the process of aging, so we can live health­i­er longer.

8- Patient-advo­ca­cy groups are hav­ing an impact. We heard many exam­ples on how small groups of moti­vat­ed indi­vid­u­als have built large patient advo­cate move­ments that influ­ence pub­lic pol­i­cy. Michael Milken talked about the Can­cer March, that helped increase NIH fund­ing from $1.5B to 5$B. Hala Mod­del­mog, from the Susan G. Komen for the Cure, explained how they have 1 mil­lion peo­ple engaged in pro­mot­ing can­cer research and pre­ven­tion. Robert Klein, key advo­cate of the Cal­i­for­nia Propo­si­tion 71 (that will pro­vide $6B for stem cell research through long-term bonds) explained how the propo­si­tion was passed, includ­ing engag­ing over 80 patient-advo­ca­cy groups.

9- There’s a new empha­sis on under­stand­ing “how sys­tems work” instead of “how iso­lat­ed genes make things hap­pen on their own”: Genomics is start­ing to help pre­dict sus­cep­ti­bil­i­ty to dis­ease and to ther­a­pies. Now, we must remem­ber the dif­fer­ence between strong and weak genes (only spe­cif­ic com­bi­na­tions of which may cre­ate pre­dis­po­si­tions), and keep in mind the role of our expe­ri­ence and envi­ron­ment in turn­ing some genes on or off. Reg­is Kel­ly pro­vid­ed a won­der­ful overview of neu­roimag­ing, learn­ing and neu­ro­plas­tic­i­ty, and high­light­ed how many biol­o­gists are mov­ing from think­ing about “how genes make things hap­pen” to “how sys­tems work”, giv­en than in humans manip­u­lat­ing just one gene may trig­ger changes in 500 oth­ers.

10- The impor­tance of our Lifestyle-Each of us owns our own health. 70% of heath­care costs derive from lifestyle-relat­ed dis­eases (such as smok­ing-induced can­cer). We heard sev­er­al calls to action for insur­ance com­pa­nies to incen­tivize behav­ior mod­i­fi­ca­tion to pro­mote good lifestyle habits that improve qual­i­ty of life and can delay dis­ease symp­toms, result­ing in bil­lions of dol­lars of cost sav­ings. Yet, in my view, the dis­cus­sion was too con­cep­tu­al in this area, and not spe­cif­ic or action-ori­ent­ed enough.

In short, a very stim­u­lat­ing inau­gur­al 3‑day con­fer­ence. I hope the one next year is even bet­ter, and includes more in-depth con­ver­sa­tions on the role of pre­ven­tion and lifestyle in dri­ving health out­comes, and builds more bridges with neu­ro­science and psy­chol­o­gy. I would sus­pect the top­ics dis­cussed in our Neu­ro­science Inter­view Series will have sig­nif­i­cant impli­ca­tions on the grow­ing health­care and pre­ven­tion debate.

Update: you may enjoy the post The Alfred Nobel lega­cy: 2007 Nobel Prizes.

Leave a Reply...

Loading Facebook Comments ...

Leave a Reply

Categories: Health & Wellness, Technology

Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

About SharpBrains

As seen in The New York Times, The Wall Street Journal, BBC News, CNN, Reuters,  SharpBrains is an independent market research firm tracking how brain science can improve our health and our lives.

Search in our archives

Follow us and Engage via…

twitter_logo_header
RSS Feed

Watch All Recordings Now (40+ Speakers, 12+ Hours)