Health+equity+tech -- 2023 Global Focus

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• This year,  StartingUpGood is focusing on small organizations  (emphasis on women and people-of-color led) who are implementing fresh, entrepreneurial approaches to  designing and implementing  technology tools to improve everyone’s health, regardless of income. 

• We are using a broad definition of health -- including other life factors that  influence health equity in positive and negative ways -- education, unemployment, wages,  job insecurity, nutrition, food insecurity, and housing.   

• We advocate for user-friendly technology and scalable investments in community-driven health solutions. 

• Acknowledging that both racial and economic disparities exist in US and Global healthcare is not new. 

• COVID’s disproportionate impact on historically underserved communities has only magnified longstanding gaps in health outcomes, such as mortality, morbidity, life expectancy, and healthcare expenditures.  

• New technologies that enable us to connect with each other or share and analyze massive amounts of information provide opportunities to improve health outcomes for everyone — but only when they are designed and implemented with health equity in mind. 

• We are using data, research, and networking to identify community-based organizations who are implementing fresh approaches, emphasizing technology and  data, to solve for health inequities. 

• We will choose projects where our team’s skills are a fit with organization-defined needs and led by people eager to enter into a mutual learning experience.

• For those selected, we plan to support them in finding the resources they need to improve, expand, and share their work.

•  We believe that strong management and infrastructure are core enablers for organizational success. Therefore we will be emphasizing leadership, communications, information systems  and fundraising enhancement in our work.

• As we have done with past projects, we will tailor our work based on the specific needs of the organization, with the goal of not burdening resource-strapped leaders with requests for information that is available to us through public source.

• We will make a donation to organizations we invite to enter our selection process as remuneration for the valuable time of their leadership in helping us determine whether there is a good fit between what they need and what we can offer.

• There will be no cost to the organizations -- we work on a pro bono basis only.

• We will share our learnings with the broader community through StartingUpGood’s social media platforms.    

• Lots of people and companies are paying attention Health Equity – from  traditional healthcare players like Bristol Myers Squibb and CVS Health to tech giants like Amazon Web Services and Best Buy.  

• We are also seeing more social enterprises --  both for-profit and not-for-profit increasing their focus on tech as a health equity enabler.   

• COVID-19 heightened our collective awareness of racial and economic health disparities because, while anyone could contract COVID, low-income people and People of Color were more likely to get very sick or die from COVID. These groups were also more likely to either lose their jobs or work in front-line jobs during the pandemic.    

• Health technologies designed with the end user in mind and designed for equity are not often the most advanced technologies, but they are the right technology for the right person in the right situation at the right time. This is a cornerstone of person-centric care, where the person who is receiving healthcare what access works best for them.   Health technology misses the mark when it doesn’t put the end user first or include diverse populations in designing products and programs.  

•  Community based organizations play a core role in accessing and building trust with historically underserved populations.   

• Grassroots organizations are critical for addressing many factors outside of healthcare – those Social Determinants of Health (SDH) – that prevent economically disadvantaged people from being as healthy as possible.  

• Heath Equity is a term used in many ways by many different groups. 
• We are using the Robert Wood Johnson Foundation (RWJF) definition.  
• “Health equity means that everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care.” 
• Source: https://www.rwjf.org/en/library/research/2017/05/what-is-health-equity-.html 
• This definition includes a lot of hard-to-tackle factors that contribute to health equity, which are often referred to – at least in academic and clinical settings – as “Social Determinants of Health” (SDH).  

• The World Health Organization defines SDOH as:   “The social determinants of health (SDH) are the non-medical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies and political systems.”  
• The WHO lists several examples of factors that can influence health equity in positive and negative ways, including education, unemployment and job insecurity, food insecurity, and housing.   
• The WHO also states: “Research shows that the social determinants can be more important than health care or lifestyle choices in influencing health. For example, numerous studies suggest that SDH account for between 30-55% of health outcomes. In addition, estimates show that the contribution of sectors outside health to population health outcomes exceeds the contribution from the health sector.”  
• Source: https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1  

What we take away from these two level-setting definitions is that Health Equity is a complicated issue. 

The Social Determinants that play a major role in achieving Health Equity are broad, complex, and intertwined.  For years, many dedicated professionals have worked to reduce health inequities. So why do we think the opportunity to create real impact is now?   

The short answer is technology. At no time in human history have we been able to connect with each other or share and analyze massive amounts of information in the ways that new technologies allow.  

The COVID-19 pandemic forced many people to quickly develop and adopt new technologies. 

• We were forced to work, learn, and shop remotely so many of us became more comfortable with digital health options, including telemedicine. 

• Health systems changed to pay equally for in-person and virtual visits out of necessity, creating health access for many rural and medically underserved populations.  

Of course, advancing health equity is more complex than simply the capability and acceptance of new technologies. Technologies that improve to health outcomes can, and often do, unintentionally widen disparities.   For example, not everyone benefited from telehealth during the pandemic shutdown. Those without access to technology (computers, devices) or connection (broadband, cell service) and those who don’t trust that their health data would remain private and secure, received less access to care.