Healthcare innovation and technology have helped solve some of medicine’s biggest problems. Despite this progress, disparities in the quality and access of care for people from diverse racial and ethnic backgrounds have persisted. As investment in healthcare innovation continues to grow, we see less capital go to diverse founders who are creating solutions that address issues exacerbated by social determinants of health (SDOH). We need to change the face of innovation to address the disparities in our own healthcare system. Impactful innovation happens in response to a need but barriers such as lack of funding or support can hinder the growth and development of the most innovative solutions. There has always been a need to address health disparities, yet we still have a long way to go.
Bridging the gap when it comes to health disparities starts by championing the voices of diverse founders of innovative solutions. These include people who identify with groups that have been historically or socially marginalized. For example, women, immigrants, and those who identify with racial or ethnic minority groups, have a disability or are part of the LGBTQ+ community. According to a recent study, most venture-backed startups are founded by “white, male, Ivy League-educated” individuals, and just one percent of venture-backed startups have Black founders. Supporting diverse founders is also a pathway to creating diverse innovative teams that bring together different perspectives to strengthen ideas and solutions. Interdisciplinary teams led by diverse founders will have a broader range of knowledge, skills, and abilities to help fuel innovation. There is evidence to suggest that they may create more innovative technology, and, on average, have better financial outcomes and have a documented higher rate of return. A diversity report by McKinsey & Company revealed companies in the top quartile of gender and ethnic diversity in their leadership were 21 percent and 33 percent more likely to have above-average profitability, respectively, with companies in the bottom quartile being 29 percent less likely to outperform on profits. Building diverse teams in healthcare innovation is critical to address the fluctuating needs of the providers and patients they will eventually serve.
Medicine is becoming more personalized and healthcare innovations are needed to address the different experiences of a wide range of patients. Lack of diversity in care solutions can lead to dire consequences and negative health outcomes for underserved patient populations. Maternal health, for example, is one area that is already seeing stark differences in patient outcomes of diverse patient populations. While there have been advancements in medical care, the rates of maternal mortality and morbidity, infant mortality, and pre-term birth continue raise concerns as they have been rising in the U.S., and people of color are at increased risk for poor outcomes. Supporting innovative solutions that address issues of patient experiences that often go untreated or are overlooked, elevates healthcare’s impact, and accelerates change that works towards a healthier collective.
Diverse founders and start-up teams need an innovation ecosystem to be able to thrive. In healthcare, innovation ecosystems should focus on sharing diverse expertise and guidance in solution development to ensure that solutions are being created to match unmet needs and address existing problems in healthcare. Start-up ecosystems have a vital role in supporting business growth, and offer support, resources, and services that can add value to the ways in which founders and teams grow, improving and accelerating start-up development. Innovation ecosystems have been widely touted as being critical to advancing solutions but are often not diverse or inclusionary in nature which means that many of the most creative and talented innovators are not “at the table.” In nature, an ecosystem thrives on diversity of species. In innovation, bringing in diverse voices to share clinical, research, and healthcare industry expertise can help spark and catalyze healthcare solutions. Healthcare enterprises are investing in ecosystems and partnerships to cement their position in the future of medicine, fueling growth and disruptive innovation. However, they are missing the fact that the future of healthcare is going to lie in the hands of those who think outside of the box and see the problems that need to be addressed. Diversifying the network that startups need to catalyze their solutions means investing in people, many of whom are typically overlooked and underrepresented in the industry, to create a community of innovative individuals who support one another as they work to transform healthcare.
The lack of diverse healthcare solutions is not a pipeline problem – it is partly a funding and support problem—but there is some good news. The number of start-ups founded by women quadrupled between 2009 and 2014 and continues to increase. There are also more Asian and Black innovators among newly vested founders in recent years, jumping from 17.7 percent to 25.2 percent and 1 percent to 1.7 percent, respectively. More than one-third (35.5 percent) of U.S. innovators were born outside the United States, and immigrants have started more than half of America’s startup companies valued at $1 billion or more, according to a new National Foundation for American Policy (NFAP) analysis. Although there has been a more than 500 percent increase in unicorn companies, immigrant-founded unicorn companies have grown at the same rate between 2018 and 2022. More founders are multiracial, multiethnic, multilingual, have unconventional lifestyles, have various sexual orientations and identities, and have different abilities. Although diverse startup founders and teams are often more innovative and make more money, we still see less investment in these companies.
People from historically and socially marginalized groups still experience higher rates of illness and death across a wide range of health conditions, proving costly to patients, health systems, and society. Health and healthcare disparities are often viewed just through the lens of race and ethnicity, but they occur across a broad range of dimensions — socioeconomic status, age, geography, language, sexual orientation and gender identity, ability status, and citizenship status. It is both our responsibility as well as a unique opportunity to identify the needed resources and lean into solutions that advance the health of everyone. We do not need to build a new healthcare innovation ecosystem – we need to leverage the existing ecosystem to its full advantage to truly create systematic change and provide better outcomes for all, but most importantly, for those patients often forgotten. Healthcare disparities cannot be solved without innovation, however, if we do not start looking towards diverse and inclusionary innovators, founders, teams, and systems for help, we will be missing out on some of the most talented individuals and creative solutions out there.
About Julien Pham, MD, MPH
Julien Pham, MD, MPH, is Founder and Managing Partner of Third Culture Capital, an immigrant-founded, physician-led, seed-stage VC firm focused on emerging healthtech and biotech companies that are optimizing and reshaping the experience of care for both patients and providers. 3CC invests in ‘Third Culture Individuals’- those who “don’t fit the mold” or are typically overlooked and underfunded – because we believe they possess a diversity of experiences, backgrounds, and expertise which endow them with the vision, resilience, and adaptability to be exceptional healthcare entrepreneurs and leaders.
Dr. Pham has over 15 years of leadership experience in clinical settings and in emerging medical technology companies including a decade as a serial healthcare entrepreneur (2 startups, both with exits – a digital health M&A, and a cancer gene therapy biotech IPO). He has held various research and teaching positions, and has received multiple awards including excellence in teaching awards from AOA and Harvard Medical School. He is a board-certified Internal Medicine doctor, and a Nephrologist who has received NIH research funding for translational research, and has published articles in basic and translational science, as well as in health policy fields.
He is a “Third Culture” individual who, by the age of 15, experienced 3 different cultures, growing up on 3 continents. Learning to speak 3 different languages in order to adapt to 3 different societies has deeply influenced his and 3CC’s ethos around diversity, equity, and purpose.
About Julie Silver, MD
Julie Silver, MD is an Associate Professor and Associate Chair in the Department of Physical Medicine and Rehabilitation at Harvard Medical School. Dr. Silver has a unique approach to innovation with a deep knowledge of dissemination and implementation of science as a driver for the adoption of healthcare products and services. Dr. Silver’s research and clinical work has focused on improving gaps in the delivery of healthcare services. She has held numerous leadership positions and is a former start-up company founder for Oncology Rehab Partners. She was named the Top Innovator in Medicine in 2012 by The Boston Globe, the same year her company was listed by Bloomberg/Businessweek as one of the most promising social enterprise companies.