Health Disparities and Lost Einsteins

One of the most evocative phrases I've seen lately comes from a new study from The Equality of Opportunity Project on the inequality of becoming an inventor in the U.S..  The authors decry the "lost Einsteins" in our society, i.e., "people who would have had high impact inventions had they become inventors." 

The study doesn't specifically reference the impact health disparities has on producing these "lost Einsteins," but it could have. 

Source: New York Times

I won't recount the methodology the study used, but here are its three key learnings:

1. There are large disparities in innovation rates by socioeconomic class, race, and gender
2. Exposure to innovation substantially increases the chances that children become inventors.
3. Star inventors earn more than $1 million per year, suggesting that further increasing financial incentives or reducing tax rates may have small impacts on innovation.

The problem is not ability. The authors say:

Differences in ability, as measured by test scores in early childhood, explain very little of these disparities. Children at the top of their 3rd grade math class are much more likely to become inventors, but only if they come from high-income families (Figure 2). High-scoring children from low-income or minority families are unlikely to become inventors. Put differently, becoming an inventor relies upon two things in America: excelling in math and science and having a rich family.

In his New York Times opinion piece about this study, David Leonhardt notes: "Low-income students who are among the very best math students — those who score in the top 5 percent of all third graders — are no more likely to become inventors than below-average math students from affluent families.  

It's worse than that.  Mr. Leonhardt's take on the data is as follows: 

Women, African-Americans, Latinos, Southerners, and low- and middle-income children are far less likely to grow up to become patent holders and inventors. Our society appears to be missing out on most potential inventors from these groups. And these groups together make up most of the American population.

Patents/1000 children (light to dark).  By The New York Times | Source: Equality of Opportunity Project

As Steve Case told Mr Leonhardt , "Creativity is broadly distributed. Opportunity is not." 

It is largely what happens in the childhood environment that drives the innovation gaps.  Better schools, improved nutrition, and healthier surroundings should all help, but another key seems to be being exposed to innovators who are like themselves.  E.g., being around male innovators is not as important to girls as being exposed to female innovators.  

Closing the innovation gaps -- finding these lost Einsteins -- could have a dramatic impact on innovation and thus economic growth.  The authors believe that: "If women, minorities, and children from low-income families were to invent at the same rate as white men from high-income (top 20%) families, the rate of innovation in America would quadruple."

I can't help wondering how many of these lost Einsteins are lost because of health issues.  

After all, the U.S. has some of the worst health disparities in the world.  Some of that is due to affordability of health care, some to availability of health services, some to living in "food deserts" or simply not having enough to eat (1-in-6 kids!), and some to living in unhealthy environments, such as being exposed to lead poisoning (1.2 million kids) or air pollution.  

Income matters.  Race matters.  Location matters.  Education matters. 

Look at the rates of, say, asthma, diabetes or obesity disparities across the U.S..  Or maybe homicide rates or opioid overdoses/deaths.  Or look at differences in infant mortality rates and think about the Einsteins that not only get lost, but are never even born.  

 

All those make it clearer why some of those potential Einsteins have things other than some new innovation to think about.

This is the "health care system" we've built, or allowed to be built.  These are the differences in health outcomes that we bemoan, but largely just wave at hands when it comes to actually trying to reduce them.  

For example, The Washington Post/Kaiser Health News recently reported on how it is more profitable for hospitals to treat children with asthma, usually through expensive ER visits, than to address the underlying reasons for the asthma.  And, of course, it is low-income, often minority residents that end up being victimized the most by this.

An executive at Johns Hopkins, speaking of the at-risk populations and some proposed at-home preventive interventions, conceded: "We know who these people are. . . . This is doable, and somebody should do it."

Somebody, indeed. Maybe one of those lost Einsteins could have figured out a way to do it.

Let's keep in mind that we're not just missing perhaps the next Steve Jobs or Sergey Brin.  We may be missing the next Louis Pasteur, the next Wilhelm Conrad Rontgen, the next Jonas Salk, the next William Greatbatch, or the next Craig Venter.  People who can help truly invent our way into the 21st century health care we should have.

If we only had, say, $30 billion to spend on health, we'd get the biggest bang for our buck investing all of it in public health infrastructure and initiatives.  It wouldn't look anything like our current health care system -- or, rather, our medical care system --  but it could go a long way towards reducing all those glaring health disparities.

If we managed to scrape up $300 billion, we could not only do a better job in public health but also could target some critical, high-impact medical care needs, such as enhanced prenatal care or targeted preventive screenings.   

With our current $3 trillion in health spending, though, we manage to ensure that the people who finance and/or deliver medical care, or make the drugs and devices involved in that care, do very well financially, but the rest of us, not so much -- either financially or in our health status.  

Even a lost Einstein can see that is perverse.  

Our economy can't afford to lose all those Einsteins.  Even more, our society can't afford to go on treating the health of any of us, Einsteins or not, as carelessly as we're doing now.