Day One at HLTH: “Birth in America is ripe for rethinking”

On day one of the HLTH Conference in Boston, Dr. Neel Shah, chief medical officer of Maven, was joined by Dr. Raegan McDonald-Mosley, CEO of Power to Decide and Ebony Marcelle, the Director of Midwifery at Community of Hope for a discussion about what steps can be taken to advance birth equity in the United States. The panel was moderated by Geralyn Ritter, head of external affairs and ESG at Organon.

Pathways to birth equity

The state of maternal health in the United States is dire. The U.S. is the only industrialized nation where maternal mortality rates are rising on an annual basis. Today, an American woman is 50% more likely to die in childbirth than her own mother a generation ago. Maternal and infant health is also riddled with inequity, with Black women being 3-4 times more likely than white women to die in childbirth, and Black infants twice as likely to die before their first birthday than white infants. 

The panelists discussed how these crises could not be solved by taking a siloed approach to what ultimately was a systemic issue, underpinned by racism and a long history of the healthcare community under-serving Black patients. Rather, to build a more trustworthy system for birthing people, it requires listening to and elevating Black voices — both patients and providers — and investing and training a culturally humble provider workforce.

“How a person experiences healthcare is very different from how we in healthcare think it is experienced,” said Marcelle. “We need to talk about the individuals providing care, the spaces where patients are receiving care, and acknowledge the distrust is real.”

Dr. Shah agreed: “It’s not the job of patients to be more trusting. It’s our job as a system to become more trustworthy.”

Dr. McDonald-Moseley spoke about the Black Maternal Health Momnibus, a suite of 12 legislative proposals currently being debated on Capitol Hill that would direct $5 billion toward community-based health initiatives, digital health programs, and other initiatives to advance maternal health equity. While she acknowledged that the package wouldn’t solve America’s maternal health crisis on its own, it represents a significant step forward. Quite simply, “the bill makes sense.” For individuals looking to play a role in advancing health equity for mothers and children, calling your representative to encourage their support of the bill was a good place to start, she said. 

At Maven, Dr. Shah shared how 40 percent of our providers self-identify as BIPOC, and 8 percent as LGBTQ, which allows members to request to be matched with providers that bring both the necessary technical expertise and unique lived experience. 

“We’re not checking a box at Maven when it comes to diversity, equity, and inclusion,” he said. “We’re thinking about how to deploy digital health to change who is centered in healthcare.

Conversations around HLTH

Discussion of the syndemic nature of the COVID-19 crisis was extensive throughout the first day’s session. A recent study in the Journal of the American Academy of Child and Adolescent Psychiatry found that the rate of suicide among Black girls was increasing at twice the annual rate as that of boys, with 40 percent of suicides concentrated among children 12-14 years old. “We’re dealing with three pandemics,” Dr. Patricia Ibeziako of Boston Children’s Hospital said. “COVID, mental health, and structural racism.”

Access to mental healthcare

Another key theme was the role of stigma in preventing individuals from accessing care. During a conversation about the increasing sponsorship of mental health benefits by employers, Jim Huffman, Head of Benefits at Fidelity Investments, explained that the company uses the term “emotional wellbeing” instead of mental health to emphasize the preventative nature of self-care. He also mentioned that employees don’t need a clinical diagnosis to seek support.

Emerging models for primary care

One of the liveliest debates of the day occurred during a discussion led by Maven Board member Nancy Brown of Oak HC/FT on emerging models for primary care. Amidst increasing use of technology within both legacy organizations and new entrants, the question of whether patients are better served through innovation within the existing reimbursement system, or through an entirely new, direct-to-consumer model, led to some thought-provoking, and spicy commentary. One thing’s for sure: when it comes to innovation, healthcare is where it’s happening.‍

If you’re at HLTH, we would love to meet you! Check out our page to book a meeting with our team, and be sure to catch our Founder and CEO, Kate Ryder, on Tuesday for a discussion on how Maven’s consumer-first approach has created systemwide benefits, as well as a lunchtime discussion with Anu Duggal of Female Founders Fund on innovating for underserved patient experiences.