Roundtable Brief #5: Consumer Perceptions and Market Trends in Brain Health
The Business Collaborative for Brain Health (BCBH) is a collaborative of private sector partners developing innovative solutions to cognitive health and performance throughout the lifespan. The Collaborative hosts regular roundtables to learn from experts and stakeholders and refine the work.
The January 2024 Roundtable focused on consumer views and marketplace trends related to brain health. Speakers included Caroline Montojo, PhD, President and CEO of the Dana Foundation; Katherine Johnston, Senior Research Fellow at the Global Wellness Institute; Justin Barclay, DBA, Vice President of Consumer Insights and Analytics at Tivity Health; David Parkes, Senior Policy Advisor of the Policy, International, and Research Division at AARP; Henry Mahncke, PhD, CEO of Posit Science; and Chia-Chia Chang, Coordinator for Partnership and New Opportunity Development for the Office of Total Worker Health at the National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC).
Public Opinion about Brain Health
The Dana Foundation, a private philanthropic organization based in New York City, is dedicated to supporting neuroscience. Its mission is to advance neuroscience that benefits society and reflects the aspirations of all people. Caroline Montojo, the President and CEO, introduced the Foundation’s three pillars: Dana Frontiers, which focuses on collaboratively identifying and addressing key issues at the intersection of neuroscience and society; Dana NextGen, which aims to catalyze a new generation of interdisciplinary experts to transform neuroscience and neurotechnology research and development by centering consideration of societal needs throughout the process; and Dana Education, which supports education both inside and outside the classroom to capture people’s interest and strengthen their knowledge of neuroscience and its relevance to their everyday lives.
With the assistance of Zogby Analytics on behalf of Research America in August 2022, the Dana Foundation conducted a public opinion survey focused on brain health and brain research. The poll was conducted among 1,023 adults plus an additional 1,218 adults for minority population oversampling. The findings revealed that an overwhelming majority of Americans have experienced at least one brain health condition, with depression, Alzheimer's disease or dementia, substance use disorder or addiction, and generalized anxiety disorder being the most frequent conditions. The survey also revealed that Americans consider brain health to be one of the most important health issues. Dr. Montojo mentioned that this was interesting because mental health surpassed both cancer and drug or opioid addiction, which were top concerns found in a national survey conducted in 2021, also by Research America.
The survey also revealed that a significant majority of Americans, 66%, lack understanding regarding brain health studies, with individuals in the age groups 18-24 and 30-49 reporting greater awareness of brain health research. These findings demonstrate a persistent knowledge gap and the need for increased collaborative endeavors in education about brain health. The Dana Education Pillar will take this on, and the Foundation is also focused on collaborating with partners who can disseminate information about brain health. Employers are a notable opportunity for the dissemination of brain health research and information.
Americans responded overwhelmingly positively when queried about brain health research, expressing curiosity, hopefulness, optimism, and even amazement. However, despite this optimism, caution persists, especially among African Americans, who show greater concern compared to other subgroups such as Asians and Hispanics. Concerns raised include potential misuse of brain health data, inadequate safeguards, unwanted manipulation of brain function, risk of injury or health damage, and potential social stigma or discrimination against research participants. Nonetheless, there is widespread support for increased investment in brain health research, with a majority believing that patients should have a voice in determining research priorities. This survey highlights the importance of bidirectional public engagement on ethical and societal issues in neuroscience. Additionally, employers might consider incorporating brain health education into the workplace; organizations developing brain health products should carefully weigh both benefits and risks, possibly even incorporating neuroethics to ensure alignment with community goals and values.
Market Size and Trends in Wellness and Brain Health
Katherine Johnston, Senior Research Fellow with the Global Wellness Institute (GWI), provided a brief overview of the wellness industry with a particular focus on mental wellness. Wellness is a holistic and multidimensional concept that encompasses physical, social, emotional, and other dimensions. It entails active pursuit rather than passive consumption.
The Global Wellness Economy was estimated to be $5.6 trillion in 2022, and accounts for about 5.6% of global GDP and more than half of all global health expenditures each year. The wellness economy includes 11 sectors of various sizes (as represented by the bubbles in the figure above). The industry is projected to grow by 8.6% annually over the next few years, reaching a market size of about $8.5 trillion in 2027. Growth is driven by several macro-level and global forces, including the global aging population, the rise of preventable chronic diseases, environmental crises, and the overburdened healthcare system. These forces are pushing consumer interest and values toward wellness, making it one of the biggest consumer movements in modern history.
GWI emphasizes that mental wellness is separate from mental health or mental illness, noting that mental wellness and mental illness can coexist. Given this distinction, GWI aims to help individuals and policymakers understand the importance of protecting and promoting mental wellness and providing access to tools for doing so. The institute’s work looks at the different levels of responsibility for addressing mental wellness issues at the individual and community levels by governments and the roles businesses can play.
In the mental wellness sector, it is important to note that identifying certain subsectors does not imply they are the most crucial for mental well-being; rather, these are areas where private sector businesses offer products and services. Many essential practices for mental wellness, such as healthy lifestyle habits and activities like spending time in nature or with loved ones, are not tied to commercial opportunities and are freely accessible. Thus, while the mental wellness industry focuses on specific sectors, broader practices outside commercial measurements also significantly contribute to mental well-being.
Older Consumers’ Views about Brain Health
Justin Barclay is Vice President of Consumer Insights and Analytics at Tivity Health. Tivity’s flagship program, SilverSneakers, is the nation's leading fitness benefit for Medicare Advantage and Medicare Supplement, with over 18 million eligible enrollees. Tivity Health fielded a survey among a sample of Medicare Advantage participants to understand the importance of physical and brain health in older adults. This survey defined brain health “as the overall well-being and optimal function of the brain, allowing individuals to realize their full potential over their life.” Respondents were asked about their current concerns with physical health and brain health, as well as a counterfactual question about what they expect to be concerned about five years from now. The results showed that while balance and mobility are currently the top concerns, memory loss and concentration concerns are increasing rapidly. Also, when asked about top of mind considerations for maintaining health, nearly three-quarters of respondents weighted physical and brain health equally.
When participants were asked about factors that help maintain brain health, 93% agreed that exercise, nutrition, sleep, engaging socially, managing stress, and proper diet all have a profound impact on brain health. Another data point was the likelihood of engaging in activities to maintain brain health. Between 79% and 90% of respondents were likely to engage in activities ranging from connecting socially to managing stress to maintaining a proper diet. While the appetite for these activities is driven by interest and perceived importance, it may not necessarily be driven by concern personally. The survey highlights the importance of considering both physical and mental health in the pursuit of overall well-being.
Barriers to Engagement and Brain Healthy Behaviors
David Parkes, Senior Policy Advisor of the Policy, International, and Research Division at AARP, presented two sets of survey data on barriers to engagement and brain-healthy behaviors. The first set of data summarized 15 surveys related to brain health, exploring topics such as physical activity, sleep, social engagement, nutrition, and healthy diet. The top perceived barriers to brain healthy behaviors were time, lack of knowledge about specific activities that benefit brain health, and lack of willpower, with 31% of respondents stating they don't enjoy exercise, 29% saying they lack willpower, and another 29% not considering themselves the “exercise type.” Survey respondents were also asked about sleep and what keeps them up at night. The number one reason was the need to use a bathroom. That was followed by worries and concerns. Regarding barriers to social engagement, again, the top obstacle was time, followed by simply having no desire to make social connection. This survey also asked about mentally stimulating activities, healthy eating, and hearing. Concerning mentally stimulating activities, 35% of respondents were unsure of suitable activities, with a notable proportion citing a lack of social reinforcement. Regarding barriers to healthy eating, 39% cited difficulty in maintaining a healthy diet, followed by cost-related issues and personal preferences. For hearing issues, while many found minor hearing problems manageable, 34% cited cost as a significant barrier, including insurance coverage limitations.
Another survey conducted by AARP examined the perception of dementia and the stigma associated with a dementia diagnosis. One of the major findings of the survey was that six in 10 adults believe cognitive decline is inevitable. And younger adults are even more pessimistic about losing cognitive functions. AARP found that almost 30% of adults are worried about their mental sharpness having declined. This concern is particularly prevalent among Hispanic, Latino, and Asian American adults, with younger individuals aged 40 to 49 being more concerned. The data show that with more awareness, adults would engage in various activities known to benefit brain health. David Parkes considered it unsurprising that those who are already engaged in these behaviors would engage in them even more if they knew it would benefit their mental functioning. Exercise was a particularly notable example, as it showed a large jump among exercisers who said they would exercise even more if they knew it would benefit both their body and their brain. In summary, the AARP's research on brain health and habits highlights the need for increased awareness of and support for individuals with dementia and other cognitive health issues, and the opportunity that exists to influence healthier habits by connecting action to brain health outcomes.
Market Research on Messaging Brain Health
Henry Mahncke, CEO of Posit Science, commented on some market research they have done around messaging brain health. Dr. Mahncke is deeply committed to evidence-based science, and his team has launched the flagship program BrainHQ, which is used globally. With over 200 published scientific papers from academic investigators using BrainHQ exercises, the company has been able to work across various segments, such as aging, senior living, reactive and clinical trials, and using brain training as a brain performance tool.
A recent survey conducted by Deft Research, a market research group, focused on Medicare and Medicare Advantage groups. The survey asked 585 people across the country, current Medicare Advantage members or eligible Medicare Advantage members and people aged 63 or 64 who were expected to be eligible in the next year. The results showed that 78% of respondents considered it extremely or very important to improve or maintain their brain health. Moreover, 80% of respondents agreed that there are things they can do to help maintain or improve their brain health. This represents a shift in how people think about their brain health, with strong agreement that there are steps we can take to improve it.
Overall, the surveys have emphasized the importance of brain health programs and their potential benefits in the workplace and commercial settings. Presenters agreed that survey data can change minds and help organizations develop more effective strategies to promote brain health. By partnering with specialized employers and organizations, Collaborative members hope to create a more supportive environment for individuals to engage in brain health programs and maintain their overall well-being.
Tools and Resources for Obtaining Employee Feedback on Well-Being
Chia-Chia Chang, Coordinator for Partnership and New Opportunity Development for the Office of Total Worker Health at the National Institute for Occupational Safety and Health (NIOSH), the Centers for Disease Control and Prevention (CDC), spoke about the importance of brain health and work. Job stress can lead to a host of negative effects on brain health: headaches, sleep disturbances, reduced exercise, poor dietary habits, difficulty concentrating, diminished cognitive performance, decreased recall, less verbal fluency, and reduced executive function, as well as increased risk of cardiovascular disease, anxiety, and depression. Sleep is also impacted by work, with factors such as toxic work environments, positive work environments, good supervisors, and good interactions with coworkers all affecting brain health.
The complexity of a job, including decision-making and workload, has been linked to brain health issues. Studies have found that people with lower wages are more likely to experience declines in their brain health. Additionally, job stress can result from lack of control, burnout workload, and too little work-leisure balance. However, there are aspects of work that can be beneficial for brain health, such as occupational stimulation, complexity, novelty, and continuous learning. The Office of Total Worker Health advocates for a multipronged approach to worker well-being, including brain health. This approach includes providing professional development, training, psychosocial work environment, psychosocial safety, sufficient staff, autonomy and flexibility in policies, and societal policies regarding employment and healthcare benefits. By focusing on these aspects, the Office of Total Worker Health aims to promote a healthier work environment and overall brain health.
In summary, the January 2024 BCBH meeting delved into consumer perceptions and market trends concerning brain health, featuring speakers like Caroline Montojo from the Dana Foundation, Katherine Johnston from the Global Wellness Institute, and others. Dr. Montojo highlighted the Dana Foundation’s grounding in neuroscience advancement, while Ms. Johnston discussed the projected growth of the already expansive wellness industry. Insights from Tivity Health's survey revealed increasing concerns among older adults about memory loss and concentration, indicating the importance of addressing both physical and brain health. Data from AARP underscored barriers to engagement in brain-healthy behaviors, with a call for heightened awareness of and support for cognitive health issues. Market research by Posit Science indicated a growing recognition of the importance of brain health, particularly among Medicare beneficiaries. Chia-Chia Chang from NIOSH highlighted the impact of job stress on brain health and advocated for a comprehensive approach to worker well-being, emphasizing the significance of workplace environments on cognitive function. Overall, the collaborative seeks to leverage these insights to promote brain health initiatives in commercial and workplace settings, fostering a supportive environment for overall well-being.