Ssome of the best business opportunities in health care will involve the development of technologies that analyze and address the factors that contribute to health disparities. These options have the potential to help people—especially those who remain neglected or completely underserved by today’s health care system—maintain their health through proactive, holistic care, reducing the need for doctor and hospital visits.
Social drivers of health are aspects of life that affect the health of individuals outside of health care itself. They count as much 80% of an individual’s health.
Social drivers include where you live, the condition of your housing, the food you have access to, your transportation options, how much education you have received, your financial security, and more. For example, if your living conditions mean you don’t have close access to healthy food or affordable transportation to a better grocery store, you don’t have access to a safe place to exercise, and you can’t get much sleep because of your living. You’re much more likely to eat poorly, get stressed, get sick, and end up in an emergency room.
Addressing the social drivers of health is often left to government programs and policies, which are subject to political winds and lack innovation or speed. So unhealthy lifestyles – as a result of unhealthy environments – remain a major problem. But big problems are fertile ground for innovative founders who change the world to create new enterprises.
My wife, Andrea, and I have seen firsthand the impact of social leaders. After I retired as CEO of Merck, she and I started a clinic to bring quality health care to my old neighborhood in a poorer part of Philadelphia. We quickly realized that many of the residents’ health problems were the result of their lack of access to fresh, healthy food. In fact, this neighborhood is what can be called a food desert. With little access to healthy food, people in the community must rely on processed, fatty foods and are more likely to eventually develop conditions such as diabetes and clogged arteries.
What the research shows
Social drivers of health negatively impact minority and lower-income populations at much greater rates because they are more likely to live in neighborhoods without good grocery stores; are more likely to live in substandard conditions; and are more likely to forego preventive care for financial and health literacy reasons.
almost 10% of black Americans have no health insurance, compared to 5% of white Americans, and lack of insurance leads people to delay medical care until a problem becomes dire. Covid-19 also made it clear that health care remains scarce in rural America. More than 180 rural hospitals have closed in the past 10 years, leaving many small-town residents to travel hours to see a doctor.
Improving the social drivers of health has traditionally been a matter for public health departments. There have been some remarkable successes: effective sewage systems, safer drinking water, reduced air pollution, anti-smoking campaigns and more, all adding years to the life expectancy of everyone, including marginalized people .
But the best ways to understand and address the social drivers and health disparities today are by building companies that take on solving such issues. No company can solve them all; it will require an ecosystem of interacting companies and technologies, as well as radical collaboration with existing healthcare systems.
A number of companies are leading the way, including City health, a portfolio company of General Catalyst, for which I work. Founded in 2017, Cityblock uses software and partnerships with insurers and hospitals to bring health care to low-income people. The company is now worth more than $6 billion.
Another one is father. The company realized that when seniors living alone have companionship and a little help in their lives, they are less likely to get sick and require expensive medical care. So Pope built a platform to match young people with seniors and uses the platform to offer services such as telemedicine and chronic care management that help seniors live at home and stay out of hospitals.
Here are some of the opportunities I believe founders of companies aiming to address health disparities should consider:
Data collection for social leaders
Data is key to health insurance — a new category of health care that uses technology to help each person stay healthy and manage their conditions, so they rarely need “sick care” in a hospital or doctor’s office.
While electronic medical records contain health data such as prescriptions, heart rates, and lab work, they contain almost no information about social drivers of health—and no data linking them to other medical conditions. In other words, medical professionals have no empirical evidence showing how the social needs of their patients affect their health.
According to one study published in Health Affairshealth care professionals are “often blind, clueless to both the social needs of their patients and the skills of potential community partners.”
A company that can collect data on the social drivers of health, link it to health outcomes, and analyze the data to find better ways for people to stay healthy and manage chronic conditions would be tremendous. valid. I could see a pharmaceutical company wanting to be a customer, helping him understand why drugs are more or less successful in certain populations. Health insurers would also find such information valuable.
While creating such a data set would undoubtedly be challenging, the future of healthcare actually depends on someone getting it right.
Linking health care to social services
There is a shocking lack of any kind of consolidated database of entities providing social services that can improve health. A doctor treating a patient who has diabetes and lives in a food desert, for example, can’t open an app and find a subsidized fresh food delivery service that can help the patient eat better.
Achieving health insurance means connecting all aspects of health together. Doctors should be able to prescribe a social service that would improve health as easily as they prescribe a pill. The US needs companies that make this possible.
Improving health literacy
In my old neighborhood, some people with diabetes don’t come to the clinic until their condition is so bad that a leg needs to be amputated because of diabetic circulation problems. A tool that could educate and encourage disadvantaged people to get screened for breast and colon cancer, diabetes or heart health would be extremely helpful. Many economically disadvantaged people simply do not know enough about their health and health care options to get the help they need before conditions become serious.
I see a need for a company that creates a health education app that targets marginalized populations. The “worriers” don’t need it – they tend to research (perhaps too much research!) their health conditions and have easy access to medical care. But people who aren’t so lucky need guidance that feels like it applies to them.
More virtual care
It is simply not possible to train enough doctors and build enough hospitals to provide easy access to care for every American. Quality care is particularly out of reach for those living in inner cities and rural towns. The solution, in this age of mobile devices and cloud computing, is virtual care.
Of course, telemedicine already exists. And during the early days of Covid-19, it looked like it was going to run its course. But there isn’t. Maybe it’s like the early years of video conferencing, when apps like WebEx were only used occasionally until the pandemic and Zoom hit and made video calls as common as voice calls. Zoom’s brilliance was in making it robust and easy to use. We need Zoom-like advances in telemedicine and business models that make it work for rural and inner-city populations.
Our mission at General Catalyst is to partner with founders to bring to life startups that address the social drivers of health and health disparities. Health insurance companies will shape the future of our collective health and well-being, bringing to life the technologies and solutions that enable proactive, holistic care that is truly accessible to all and serves our larger society.
Ken Frazier is head of health insurance initiatives at General Catalyst, a venture capital firm, and the current executive chairman and former CEO of Merck. He is also co-founder and co-chairman of OneTen, a coalition of organizations dedicated to improving, hiring and promoting one million Black Americans in family-supporting jobs.
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