An Open Letter: Juneteenth (June 19th)

A year ago, most Americans didn’t know what Juneteenth was, let alone its historical significance. And while I had a “trivia question” level of knowledge, I would certainly count myself amongst the undereducated majority when it comes to the significance of Juneteenth. Now, a year later, we have made this a federal holiday. To say that much has happened in the last 12 months to get us here is an understatement. Last summer saw a reckoning, as we wrestled with our history and the systemic injustice and racism that we saw through the murder of George Floyd and countless others. Last week, we saw the death toll for COVID-19 reach 600,000 in the US, a staggering number disproportionately fueled by the systemic racism that has left black and brown people most vulnerable to this disease. And for all the suffering we have endured as a nation, we are certainly better for it. We are beginning to plant the seeds of needed change.

As an industry, healthcare has begun to apply a health equity lens to all of our work, understanding that the poor outcomes that drive so much of the costs in our system are a result of inequity in access and systemic racism:

Payers and Providers – Across the country, healthcare delivery and payer organizations have focused their efforts on addressing health disparities. Both United and Humana have underscored their commitment by hiring senior executives focused on health equity, as well as diversity, equity and inclusion, including my friend and former RubiconMD team member, Dr. Nwando Olayiwola. Measuring equity is still challenging, but as organizations build infrastructure, defining and assessing impact will be critical.

Invested Capital – Venture Capitalists, the investors we spend most of our time within the startup space, have almost universally made it a priority to make investments that address health disparities, and many have worked hard to increase access to their teams for underrepresented founders.

Technology and services – Last May, we at RubiconMD raised our hand with others to say that digital health was unfortunately only exacerbating existing inequities, and hundreds of others did as well, including key leaders from across the industry. Since then, we have banded together to form Health Tech for Equity, HT4E, with Shoshanah Brown of AIRnyc, Adimika Arthur of Health Tech 4 Medicaid, and so many others to build a more equitable community solution. We are preparing to launch a community-based initiative in Harlem called the Telehealth Equity project, using telehealth and tech-based resources to build solutions for those affected by systemic racism. The initial focus is on maternal health; the goal is to drive down mortality and adverse effects in BIPOC who are giving birth, a population that is 3x more likely to die from childbirth than white people.

Policy – In NY State, a wave of funding to improve outcomes is expected to be announced later this year. In stark contrast to the funding that began in 2015, the state’s delivery system reform incentive payment [DSRIP], this wave will be more focused on funding innovation to explicitly address health disparities.

If Juneteenth marks freedom from slavery for Black Americans, we still have much work to do to ensure equality. Awareness and acceptance are certainly the first steps. But as my friend Samuel Yamoah has said, “We cannot be content to simply admire the problem.” And with our lives beginning to return to normal, it’s attractive to abandon the painful lessons of the last year and simply return to our pre-pandemic ways. As we celebrate Juneteenth, I’m hopeful that the lessons of last year will push us to create a new more equitable normal. I remain inspired and energized by the work ahead. And with a one-year-old daughter, I’m heartened to know that as she grows, she will learn about the significance of this day as a national holiday. Happy Juneteenth!

In hope,

Gil Addo