Attracting new talent at schools is not always so easy. So when the former director of talent at KIPP Philadelphia (a public charter school network) told me about his success using a new tech platform, I knew I wanted to learn more.
Selected is a teacher hiring platform that provides underserved schools access to high-quality teachers at an affordable rate. I was researching this company during my impact investing experience with the Fund for Health. Conversations with teachers and recruiters who use the platform helped me realize the important connections linking teacher quality and retention, student motivation, educational attainment, and economic outcomes after graduation.
So what is the connection between ed-tech and health equity? The social determinants of health. Before my internship at the Fund for Health, I was unfamiliar with this term — a term that is becoming increasingly common in discussions of health equity and social justice.
Social determinants of health are the conditions in the environment where people are born, live, work, and play that affect a wide range of health risks and outcomes. Social determinants of health include, but are not limited to, financial stability, employment, access to education, access to healthy food options, and neighborhood environment.
Before this internship, I had not given much consideration to the role of the private sector in shaping the social determinants of health. My impact investing experience at the Fund for Health reshaped my view of health equity and made me realize that the private sector can play a large role in reimagining healthcare for all.
Philadelphia is a microcosm of nationwide community health disparity.
As the nation’s poorest big city, Philadelphia is a microcosm for the systemic failures that have led to worse health outcomes for low-income communities of color across the United States. Over 23% of the Philadelphia population lives below the poverty line — nearly twice the U.S. average — and over one-third of city residents in higher poverty census tracts self-reported poor or fair health.
The city’s majority-Black and majority-Latinx census tracts consistently show higher chronic disease prevalence, lower life expectancies, and greater susceptibility to COVID-19. These populations also show much higher poverty rates.
Individuals experiencing poverty have higher rates of unemployment and worse health insurance coverage. People experiencing poverty also tend to live in areas with subpar living conditions, greater exposure to air pollution, and higher levels of food insecurity — factors which only exacerbate the chronic health conditions that disproportionately affect Black and Brown populations.
These disparities are just a few examples that demonstrate the need for innovative solutions that address the social determinants of health for underserved populations.
Downstream interventions will not fix upstream problems.
Before people commonly discussed social determinants of health, many of the proposed solutions to health disparities were focused on “downstream interventions.” These interventions typically involve individual-level behavioral approaches for prevention or disease management as well as strategies focused on providing better access to healthcare.
While addressing these challenges in healthcare is important, there is sometimes undue emphasis placed on downstream individual intervention approaches — such as smoking cessation or diet improvement — at the expense of “upstream” approaches. An upstream approach to care examines and addresses root causes rather than symptoms, and can thus improve long-term outcomes.
Downstream approaches alone are insufficient; upstream interventions are critical. A diet improvement or diabetes prevention program can be effective, but not if the patient does not have a grocery store in their area with affordable and healthy food options, or access to transportation that makes trips to this grocery store feasible.
One example of a company that is tackling upstream effects is State of Place. State of Place is a software startup that uses AI-powered urban design data and predictive analytics to help city makers create more walkable, livable, sustainable places and reduce spatial inequities. The company recognizes that the built environment plays a critical role in driving health outcomes. For instance, inaccessible or nonexistent sidewalks and bicycle or walking paths contribute to sedentary habits, which leads to poor health outcomes such as obesity, cardiovascular disease, and diabetes. State of Place is just one of many impact companies I sourced while interning at the Fund for Health, showing how companies across the private sector can impact the social determinants of health.
We can, and should, leverage the innovation of the private sector to strengthen the social determinants of health.
The Fund for Health recognizes the importance of upstream interventions. This focus has been incredibly helpful to me throughout the company sourcing and evaluation process. As my internship progressed, I found myself sourcing more startups that fall outside of the traditional “health” or “healthcare” space. Whether it’s workforce development and ed-tech platforms, or businesses that practice fair hiring for people with criminal records, or delivery services for food insecure populations, companies have shown tremendous ingenuity in their approaches to addressing the social determinants of health.
I am hopeful that such innovation will only continue to grow. While government and system-wide interventions to address the social determinants remain critical, the evolving startup landscape in Philadelphia and other cities across the U.S. is demonstrating the enormous potential of the private sector to fill in important gaps in community health.
— Caroline Culmo
Posted: November 22, 2021