Fortune’s annual Brainstorm Health Conference convenes a powerful group of people: executives of the world’s largest businesses, White House officials, and investors. What made this year’s conference different was that it also included powerful voices from those impacted by the health systems failures.
As Fortune CEO Alan Murray observed on his podcast Leadership Next, healthcare conferences often vacillate between the cutting edge of innovation — stethoscopes that use AI to diagnose heart conditions — to the incredibly basic, such as the Surgeon General’s call to address loneliness.
On the basic stuff — the foundational challenges that healthcare struggles to get right — I’ve learned that the answers and solutions we seek are found in the community of those who have lived and embodied experience with health system failure.
So with the support of conference co-chair Deena Shakir, we held a panel on Black Maternal Health that included Professor Loretta J. Ross, reproductive justice icon; Charles Johnson, a relentless advocate and founder of 4Kira4Moms; and Dr. Irogue Igbinosa of Stanford University Medical School.
I’ve been on a lot of panels in my career but this one stands alone as my favorite. You can view in full here, but here are some of the takeaways.
Black maternal health is population health
Since the death of his wife Kira, Charles Johnson has been a tireless advocate for improving maternal health outcomes for Black women in the United States. This advocacy helped lead to the passage of the Preventing Maternal Deaths Act of 2018, which made national data more accessible and has dramatically reshaped the maternal health landscape.
Today, Charles is part of the team pushing to see the Black Maternal Health Momnibus set of bills passed into law. This sweeping legislation includes investments in the birth workforce, telehealth services, and more, interventions that will directly address issues that Black women and birthing people face with regards to access, affordability, and quality. But these policies, while deliberately designed with a race-conscious lens, will also strengthen the overall system by increasing the supply of practitioners and making innovative and evidence-based resources more readily available. As Charles said, “When we fix this for Black women, we fix it for everybody.”
“When we fix this for Black women, we fix it for everybody.”
- Charles Johnson
Digital health’s role is to help restore trust
An app won’t fix healthcare or end racism. But there are some things that digital health is uniquely suited for, particularly when it comes to addressing systemic challenges like the Black maternal health crisis.
We discussed three in particular during the panel. One, digital health can make healthcare more competent by improving outcomes, which will require building solutions based on scientific evidence and reporting with transparency and accountability. Two, digital health can make healthcare more affirming by increasing access to culturally humble support, for example by matching patients with providers who share their lived experience. And three, digital health can make healthcare more reliable by making sure that healthcare is there when patients need it. This is an area where the traditional brick-and-mortar system is especially ill-equipped, and one of the main reasons I joined a digital health company two years ago. So much of our health happens outside the four walls of a clinic. At its best, digital health can meet people where they are with the right resources at the right time.
Build for the ceiling
It’s because healthcare happens within communities that our efforts to stem the Black maternal health crisis have so often fallen short. More than half of all maternal deaths occur after birth, and Loretta noted that in order to resolve our crisis, we have to start thinking more expansively about what actually accounts for the health and wellbeing of mothers.
“Too many times, people are describing Black maternal health, mortality, maternal mortality as either a genetic issue or a behavioral issue, but not as a sociopolitical issue,” she said. “We have to be able to look at these outside influences that aren’t about race, that aren’t about behavior, but about the conditions that we’re creating as a society that we’re failing to address.”
I believe that doing so can lead to a system that isn’t merely about avoiding the worst possible outcomes, but about achieving a real leap forward in quality of life. Dr. Igbinosa reminded us that joy was one of the themes of Black Maternal Health Week this year. As she said, pregnancy is a time of inherent hopefulness and optimism, of looking forward. While ending preventable maternal mortality and morbidity is essential, surviving pregnancy is the floor of what healthcare should aspire to offer patients. Instead, we should aim to design a system that is empowering, one that treats pregnancy and childbirth as a springboard to lifelong health and wellbeing for mothers and their families.
What my team is reading, considering and building against
A recent piece in the New England Journal of Medicine described how health systems and other organizations might benefit from adhering to a philosophy of ‘digital minimalism’ when considering how and when to adopt new technologies in the clinical setting. The authors distill the framework to three key points: “clutter is costly, optimization is vital, and intentionality is satisfying.”
Earlier this month, the World Health Organization released its first report on infertility in a decade, finding that 1 in 6 people globally suffer from the disease. Along with the report, the WHO funded research published in Human Reproduction Open about the catastrophic expenses associated with out-of-pocket fertility care, particularly for those in middle- and low-income countries. The authors found that many patients faced costs that were equal to or greater than an entire year’s salary, threatening those who wished to grow their family at risk of financial ruin and underscoring the importance of treating fertility care less as luxury, and more as core healthcare.
A Swedish team studying birth outcomes following ART published an intriguing research letter in JAMA that found that lesbian couples saw lower rates of birth complications than heterosexual couples with a clinical diagnosis of infertility. The findings suggest that ART on its own may be less of a contributor to poor outcomes than the condition of infertility itself, with implications for how we support these patient populations that warrant further study.
Substance abuse is the underlying cause in a large and growing number of maternal deaths. In JAMA Psychiatry, a team studying the use of telemedicine among Medicare beneficiaries with Opioid Use Disorder found that patients with access to support and medication through digital means showed reduced overall mortality, findings that underscore the critical role that enhanced access plays both in terms of convenience, and, I suspect, stigma, in reducing barriers to life-saving care.
I meant summary!
Thank you for this insightful summer. As an Ob/Gyn Physician and Reproductive Endocrinology & Infertility specialist and black woman, I’ve seen these issues first hand and in my own personal experience. I went into medicine to give patients a voice. Digital Health care, once it is accessible to more people and especially black families has the opportunity to improve people’s experiences in the health care system to one of invisibility and being a problem/statistic to one of joy. I am proud to be part of the Maven community and what Maven is doing to make health care more accessible and equitable.