Healthcare in Space, Part I: A First Principles Approach to Solving Earth’s Healthcare Deserts

Introduction

For a country that spends over $4 trillion annually on healthcare, it's shocking that approximately 30 million people in the US live in healthcare deserts, where basic access to care (pharmacies, PCPs, hospitals, etc) is lacking.

In a country where healthcare costs are skyrocketing at a ~4% annual growth rate (don’t forget, that’s an additional $160 billion spent a year), the existence and expansion of these deserts are paradoxical and troubling.

So why is this happening?

• Provider Consolidation: In an effort to increase operational efficiency, healthcare providers are merging and consolidating. While this can lead to cost savings and improved service delivery in well-populated areas, it often results in the closure of facilities in less profitable, rural regions, leaving these areas underserved.

• Staff Shortages: The healthcare industry is facing a critical shortage of qualified professionals. This shortage is exacerbated in rural and underserved areas where attracting and retaining medical staff is particularly challenging for a whopping 90% of rural counties due to factors such as lower salaries, professional isolation, and fewer opportunities for career advancement.

• Economic Disparities: Rural areas often lack the financial resources to support healthcare infrastructure, leading to a vicious cycle where the absence of adequate healthcare services further stifles economic development and population growth.

The challenges faced by healthcare deserts are complex and multifaceted, and any fixes within the existing healthcare framework are unlikely to address many deep seated (racial, socioeconomic) issues effectively.

In these moments of complexity, a first principles approach is our best bet to think of ways to solve the healthcare desert problem.

What better way to do that than by paying homage to the person who most recently popularized the term 'first principles thinking’?

To break free from our earthly thinking, we will attempt to channel our inner Elon Musk and try to rebuild healthcare on Mars alongside the first settlers, and see what lessons we can learn to apply back on Earth.

We’ll start first by establishing some baseline knowledge, so without further ado, let’s jump…..I mean, lift off!

What are the demographics of the first Mars settlers?

Healthcare is fundamentally a human endeavor, so it stands to reason we must understand who we will send there first. Assuming these initial space farers would have to pass the same rigorous testing and training as current astronauts do, past candidates have ranged from ages 26-46, putting them in the relatively healthy young adult - middle age range.

How many medical personnel do we need?

Given the harsh and isolated conditions on Mars, healthcare will be a critical component of the mission. The WHO estimates that a ratio of 2.5 medical staff (physician, nurse, specialist) per 1000 people is needed in order to maintain a healthy population.

If Elon’s plans to send a million people to Mars is taken at face value, we’ll need to find 2500 qualified medical personnel to go to Mars.

What are the early settlers’ healthcare requirements?

Considering early settlers will be braving the elements and focused on setting up a base of operations for future travelers, we’ll need to prioritize healthcare services towards the realities of setting up a base of operations on Mars by asking two key questions:

What type of jobs will settlers perform?

A highly skilled group of individuals will be needed to ensure the success and sustainability of the Martian colony. Beyond the aforementioned healthcare personnel, the initial settlers will likely include :

• Engineers and Technicians: These individuals will be responsible for constructing habitats, maintaining life support systems, and ensuring the functionality of various technological systems. They will constitute a significant portion of the initial settlers.

• Scientists: Experts in fields such as biology, geology, and environmental science will be crucial for studying the Martian environment and developing sustainable living solutions.

• Agricultural Specialists: These experts will work on developing sustainable food production systems, crucial for long-term survival.

• General Support Staff: Individuals with skills in logistics, administration, and general maintenance will be needed to support the overall mission.

  

What environments will they be living and working in, and what are the potential health risks?

Given the unique environment that the Mars surface presents, and the specific work that they will be performing, we can focus initial healthcare focuses on the most likely needs, including:

Microgravity:

• Muscle Atrophy and Bone Loss: Extended exposure to microgravity leads to muscle weakening and bone density reduction, as seen in astronauts aboard the International Space Station (ISS).

• Cardiovascular Deconditioning: The heart and blood vessels may weaken due to the lack of gravitational force, impacting cardiovascular health.

Radiation:

• Increased Cancer Risk: Exposure to cosmic radiation and solar particles increases the risk of cancer and other health issues due to DNA damage.

• Acute Radiation Sickness: High levels of radiation exposure can lead to acute symptoms such as nausea, fatigue, and skin burns.

Isolation and Loneliness:

• Mental Health Issues: Prolonged isolation and confinement can lead to depression, anxiety, and other mental health disorders.

• Social Withdrawal: Lack of social interaction and support can exacerbate feelings of loneliness and stress.

On-the-Job Injuries:

• Physical Injuries: Injuries such as cuts, bruises, fractures, and burns can occur during construction, equipment maintenance, and scientific experiments.

• Repetitive Strain Injuries: Tasks that involve repetitive motions, such as operating machinery or conducting laboratory experiments, can lead to musculoskeletal disorders.

• Chemical Exposure: Handling chemicals and biological samples can pose risks of exposure, leading to acute and chronic health issues.

Conclusion

Undoubtedly, the biggest challenge in Elon’s quest to populate Mars is getting there in the first place. Putting that technicality aside, Mars provides a clean slate for us to conduct our thought experiment. By understanding who these settlers are and what challenges they’ll face as they embark on their great exploration, we can imagine how we’d build healthcare from the ground up.

What kind of specialties should we prioritize, and how would we actually deliver care on Mars? Join us next week as we go further down the rabbit hole of building healthcare for Mars!

Don’t go to space alone; bring a friend! Share our newsletter, and stay tuned to our newsletter for more insights into healthcare innovation.

Want to invest in space-age, cutting edge medical technologies? Join us at The Healthcare Syndicate as we back the most ambitious founders 10Xing the standard of healthcare!