Brain Drain. As nefarious as this phrase sounds, it represents a real problem for the greater St. Louis community. Brain Drain, also called human capital flight, is the movement of educated and professional individuals from one geographic location to another for better pay or working conditions. In the case of St. Louis, many recent graduates from Washington University in St. Louis (WUSTL) and other St. Louis colleges and graduate schools leave the city for larger cities, such as Chicago, New York, and Los Angeles.
The problem of Brain Drain is particularly apparent when it comes to the medical field. According to Robert Fruend, Chief Executive Officer of the St. Louis Regional Health Commission, St. Louis is actually a model city when it comes to community health. St. Louis city and county were selected by the Centers for Medicare and Medicaid Services to participate in a pilot project called “Gateway to Better Health.” Through this program, St. Louis receives $30 million in federal funds each year to provide primary, specialty, and urgent care for uninsured adults in the St. Louis metropolitan area. Many of these adults do not qualify for Medicaid, the federal program for that allows low-income families and individuals to receive medical care. Since St. Louis does not have a public hospital to treat uninsured patients, Gateway funds several community health centers where patients can seek treatment.
Fruend noted how the Patient Protection and Affordable Care Act (PPACA) will affect the Gateway program. One of the many goals of the PPACA is to expand healthcare coverage of millions of Americans by means of expanding Medicaid. More people will qualify for Medicaid as qualifying income thresholds are raised.
After intense debate over the constitutionality of the PPACA, the Supreme Court determined that individual state legislatures can decide whether they wish to expand Medicaid. Missouri opted not to expand Medicaid, creating problems for programs like Gateway. Federal funding of Gateway will be siphoned away to other states’ Medicaid programs. With funding removed, the future of Gateway and the health of St. Louis is uncertain. Further, many doctors and other healthcare professionals now flee from St. Louis and the state of Missouri. They instead go to states that have expanded Medicaid because these states have more funds available to compensate health care professionals. Thus, St. Louis is on the verge of a large-scale physician shortage.
There are potential solutions to the problem of Brain Drain. A group of WUSTL alumni, all sharing a love of St. Louis and a willingness to work for change, stuck around in St. Louis after graduation. They formed a group called “Brain Drain.” This collective hopes to retain more young professionals in the St. Louis area by discussing ways to make St. Louis more appealing to this group. To start off, the group created a project called CityPulse, which studies the demographics of different neighborhoods in St. Louis by using mounted cameras. The data will give the group a better idea of where people are and what they are doing. For instance, in a neighborhood with high levels of bicycle traffic, that neighborhood can become more bike-friendly by adding bike lanes. In this way, CityPulse seeks to improve neighborhoods in St. Louis by tailoring developments to community-based needs. Improvements are evident in places such as Washington Avenue in downtown St. Louis, where vacant buildings have been renovated. The street is now known for its vibrant nightlife and the abundance of loft-style housing. With similar neighborhood improvements, St. Louis will become a more livable city and likely retain more professionals.
Recent WUSTL alumni Audrey Chan, originally from the San Francisco Bay Area, made the decision to stay in St. Louis. “During my years of undergrad I felt that I had not yet fully experienced what St. Louis has to offer as a city, and so that was a factor in my decision to stay,” Chan said. “Second, the different job prospects were a major factor. For me, St. Louis has more opportunities in my field versus going back to the Bay Area where WashU has not quite yet established the reputation it deserves. I would have to compete with graduates from Stanford and Berkeley that are more well-known there. Third, I like the people and the culture of St. Louis. People are very well-connected and it’s a great place to build up a network.”
Within WUSTL, some initiatives are already in place to encourage students to gain exposure to St. Louis. For example, the Gephardt Institute, offers the Goldman Fellows Program, which offers a $3500 stipend to students who spend the summer in St. Louis working on a community-based project. The program exposes students to the St. Louis community outside of WUSTL, hopefully sparking long-term interest in the city. Other long-term community service initiatives, such as Pre-O program Leadership Through Service, also provide additional exposure to the St. Louis area, allowing students to explore all that the city offers.
Brain Drain is not inevitable. St. Louis college students are at a fork in the road. We can choose to change the city by using the tools available to us and sticking around after graduation.