We are excited to update you on the rest of our top sessions from Spotlight Health. We learned so much about neuroscience (in regards to health outcomes), the opioid epidemic, and the changing landscape of healthcare. We were also lucky to hear a few star speakers, from all sides of the aisle, at the Spotlight Health closing ceremony.

1. Our brains are complicated and fascinating, and we do not understand exactly how they work. Yet by hearing from some of the leading experts in neuroscience, we can better understand how our upbringing, through education, socioeconomic status, and place of birth, influence our brains and related health outcomes.

• In The Neuroscience of Poverty, Martha Farah, neuroscientist at the University of Pennsylvania, found that the development of the hippocampus and prefrontal cortex is determined by peoples’ location of upbringing, as people living in difficult, poverty-stricken locations tend to have underdeveloped hippocampi and prefrontal cortices. However, David Leonhard, op-ed columnist at The New York Times, said that there is a linear effect on time of movement; there is no one critical age after which brain function declines depending on location. While it is better for children to move out of undesirable neighborhoods earlier in life, there is no time in which a child is a lost cause. Angel Kyodo Williams, founder and senior fellow at the Center for Transformative Change, said, “Neuroscience can help us understand that kids raised in poverty are not bad kids.” There are some behavioral practices that can help people in difficult circumstances thrive. For example, strong, loving relationships and meditation/mindfulness are able to buffer the effects of poverty on development.
• In Applying Neuroscience to the Classroom, we learned about the ways that adverse childhood experiences (ACEs) severely affect how children learn. Nadine Burke-Harris, founder and CEO of Center for Youth Wellness, said that there are immunological consequences of ACEs that keep children out of the classroom. There are also neural consequences of ACEs that disrupt learning when children are in the classroom. Sarah Watamura, associate professor of psychology at the University of Denver, talked about protective factors for children who experience ACEs, most importantly through healthy relationships and the support of adults. Burke-Harris agreed, saying, “Safe, stable, nurturing relationships are the antidote to toxic stress.” In both talks, we heard that healthy relationships are crucial in development, especially for children who face difficult environments.

2. In The Opioid Tsunami, Surgeon General Vivek Murthy, among others, discussed the tragic toll of the opioid epidemic, largely on underserved white communities. Murthy discussed the Turning the Tide Campaign, an intervention he created about the opioid epidemic by sending a letter to 2.3 million healthcare providers. He urged clinicians to take responsibility for their patients who are addicted to opioids because, no matter how well-intentioned physicians are, they may have contributed to the epidemic through over-prescribing certain medications. He did not blame physicians, but instead wrote about the opportunity they have to redefine addiction as a chronic disease of the brain. Physicians can, and have the responsibility to, change how they prescribe opioids, get people the treatment they need, and educate the public about addiction as a chronic illness.

3. Of the many programs offered by the Aspen Institute, the Health Innovator Fellowship is unique in its support for those who are changing the healthcare landscape in the United States. As part of the “Visionary Leaders: The Aspen Institute Health Innovators Fellowship” session, we were fortunate to hear some of the fellows speak.

• We heard Shannon Jaccard, CEO of NAMI San Diego, speak about the stigmatization of mental health. People with mental illness die on average 25-years earlier than people without mental illness, and the leading cause of death among this group is suicide. Although social movements and other interventions have decreased the stigma around mental health, the U.S. mental health system has failed us. When mentally ill patients seek help, they are frequently handcuffed, put in the back of a police car, brought to a small, bare room in the hospital, and tied down. Once this negative impression of the hospital is implanted in patients, they will seldom go voluntarily. We need hospitals to be seen as tools for care. Considering that 1 in 5 people in the U.S. have a mental illness and 1 in 4 caregivers provide for someone with one, we must end the stigma on mental health and care for patients in safe institutions where they feel comfortable enough to heal.
• We also had the opportunity to hear Rebecca Onie, CEO of Health Leads, speak about the environmental factors of health – food, housing, transportation, and beyond. Seventy percent of health outcomes depend on environmental factors outside of the hospital, yet we do not address this large component of population health. Onie argued that we should maintain a registry of food insecure patients, just like the one we have for heart disease. You can provide patients with excellent care in facilities, but once they return to the same environment, they can relapse and the care may be rendered useless. Strikingly, there are on average only about 2 social workers per 24,000 pediatric patients – and doctors don’t learn about housing or food pantries in medical school. Healthcare providers must take environmental factors more seriously and prescribe solutions beyond pharmaceutical drugs – fruits and vegetables, adequate exercise, local community housing, etc. – in order to achieve true health outcomes.

4. At the Spotlight Health Closing Ceremony, we had the honor of hearing the diverse perspectives of three key leaders: Tom Price, U.S. Secretary of Health and Human Services; Larry Brilliant, one of the leaders of the World Health Organization’s smallpox eradication project; and Cecile Richards, President of Planned Parenthood.

• Tom Price talked about the repeal of the Affordable Care Act (ACA) and the desired implementation of new American Health Care Reform bill. He lamented that certain small businesses cannot expand due to restraints set by the ACA, which specifies that businesses with over 50 employees must offer health benefits. Price also questioned the efficacy of the ACA, claiming that there are still 28 million uninsured Americans and that medical bankruptcy is a uniquely American phenomenon. We want a system that incentivizes innovation, empowers patients, and promotes accessibility, quality, and affordability – and Price believes the recently introduced Senate bill is on track to do this. However, his praise of the bill was not shared by most of audience, who are understandably terrified by the projections that the bill will leave 22 million more Americans uninsured.
  
• Larry Brilliant took a bipartisan approach, discussing how we have evolved into such a harsh and acrimonious country, especially when debating healthcare. He criticized the clandestine development of the new healthcare bill and how our political system no longer represents the views and needs of American patients. Brilliant denounced the deliberate use of divisiveness as a political tool and called for a more bilateral, unified approach to healthcare reform.
• Cecile Richards used her platform to represent the left and uphold the ACA. Planned Parenthood, a lightning rod among conservatives,  is at risk of losing funds for prevention services under the proposed Senate bill (Planned Parenthood was never given government funds for abortion in the first place). Richards pointed out the severe impact this bill would have on the millions of people who go to Planned Parenthood each year for cancer screenings, STI tests, contraceptive access and education, abortion services, and beyond. Richards highlighted the integral role of women in the economy and the consequences that ensue when women do not have the right to birth control and contraceptives, giving others the right to decide if and when they will have children.

After an amazing four days, we are sad to see Spotlight Health come to a close. We have shared our most important insights with you, but click here to watch more videos from the leaders in the field. We learned so much about healthcare—the biggest challenges, successes, and ideas for the future. We look forward to following these leaders as they continue to think critically and innovate for our future.