Approximately 60 percent of a person’s life expectancy is driven by social and environmental factors. The social determinants of health are the factors that affect life expectancy outside the doctor’s office, like education, income inequality, food security, housing, the physical environment, gender, race, and vulnerable populations. These factors have not traditionally been viewed through a health lens and need to be considered in an integrated fashion, engaging collaborators across disciplines.
We cannot continue to work in our various silos to address these underlying determinants of health. In order to tackle these determinants, we need to bring together players from various sectors, including both private and public, to create innovative solutions to address these social determinants of health. The Aspen Global Innovators Group is committed to stimulating conversations around social determinants of health by building an action-oriented ideas lab for decision-makers to work together on complex ideas.
The Aspen Ideas Incubator kicks off the annual Aspen Ideas: Health conference by gathering over 40 global and community health experts and practitioners to workshop three innovative ideas that tackle social determinants of health. Using an explicit equity lens, the group participates in a curated set of conversations to drive new insights, actions, and commitments.
On June 18-20, 2019, the 2019 Aspen Ideas Incubator tackled the following questions:
- How do we scale food entrepreneurship to improve health outcomes and strengthen local economies? What could FoodLab Detroit look like at scale while staying true to its values and mission?
- How could access to nursing education and training be more equitable, and address maldistribution and retention issues? How can innovative financing mechanisms such a as loan funds, income sharing agreements, social impact bonds, and crowdfunding platforms compliment other forms of philanthropic support to address this challenge?
- How can employers lead the way in addressing diabetes, obesity, and heart disease (also known as “chronic lifestyle diseases”) for their low-income employees and their communities through social need and social determinants initiatives?
Devita Davison, Executive Director of FoodLab Detroit, launched the 2019 Aspen Ideas Incubator with a mission to grow FoodLab Detroit in a way to make it more accessible for other food entrepreneurs to change lives in their own communities. Many communities are being labeled as “food deserts,” but that term does not take into consideration the enormous potential of cities like Detroit. Devita declared that FoodLab can be an example model for other communities and by staying in Detroit and continuing to grow the network of food innovators and entrepreneurs will create a roadmap for other communities.
Alice Lin Fabiano, Global Director of Social Innovation at Johnson & Johnson, presented the second idea with a commitment for Johnson & Johnson to support nurses and midwives domestically and globally. Johnson & Johnson wanted to tackle the financial barriers that nurses and midwives face, understanding how innovative financial mechanisms can play a part in reducing the burden. At the same time, Johnson & Johnson is working on how to best position their company to be able to strategically make the highest impact for nurses and midwives.
Finally, Larry Wolk, Chief Medical Officer of The Wonderful Company, introduced the growing participation of the private sector to address social determinants of health. The Wonderful Company has decided to take on this challenge by providing free primary medical care and prescriptions to their employees, introducing mobile clinics in nearby communities and providing on-site wellness programs. Making the case that these programs benefit the private sector is necessary, but how can we effectively get other companies to adopt these types of initiatives?
These three issues – and their corresponding solution ideas – were workshopped by the full Aspen Ideas Incubator group, including representatives from the Campbell Foundation, Last Mile Health, USAID Center for Innovation and Impact, and Social Finance. During two full days of expert-led discussion and collaborative workshop sessions, the group uncovered assumptions, developed new paths forward, and unlocked commitments from public and private sector partners. Three key solution ideas emerged:
- The creation of the Dream Café. Early in the Ideas Incubator, Devita Davison shifted her focus from scaling her organization to creating a vision of the Dream Café: a café that embodies the spirit of Devita’s vision and FoodLab’s vision of their community. The group worked on creating a concept of a café that will buy from local farmers to produce Detroit-based dishes. With input from Agnes Binagwaho, Vice Chancellor of the University of Global Health Equity, Devita agreed that this café would link her advocacy work with her community-based initiatives. The group recognized that the success of the Dream Café will not only be great for the local community but be a charge for communities throughout the United States to think about buying locally-grown food.
- Three big ideas to address the shortage of nurses and midwives. The full Incubator group developed three big ideas that address the major opportunity for Johnson & Johnson to expand their current philanthropic funding methods to move towards a more sustainable approach. The first takes on the charge of assisting in the funding of more culturally competent midwifery programs that will support midwifery programs that are working on the local level. The second big idea the Incubator group developed was designing a nurse and midwifery financing facility that addresses the financial barriers to becoming a nurse or midwife. Finally, the Incubator group also agreed that there is an opportunity to create the Aspen Declaration on Nursing and Midwifery, which would bring more attention to nurses and midwives internationally. This group stated:
“The time has come for putting nurses and midwives at the center of health delivery. To recognize the pivotal role they play in bridging communities, health systems, and achieving universal health coverage, and in celebration of the 200th birthday of Florence Nightingale, and the 2020 year of the nurse/midwife, we at Aspen invite global, regional, and national stakeholders to join us in bringing forward efforts to ensure that every mother, father, newborn, child and adolescent has access to quality nursing and midwifery care.”
Recognizing that health is a human right and that nurses and midwives are the center of care throughout the world, this group recognized that a public call to action was needed.
- Employers need to see the health of their employees as an investment. Employers are continuously seeing rising health care costs for themselves and their employees. However, creating programs that address chronic health care costs is expensive. With this in mind, the Wonderful Company has taken on the challenge of understanding the best evidence-driven programs that employers can undertake that will allow them to help their employees. The group agreed there needs to be a creation of a scorecard where employers can self-identify the programs, they are able to create based on the type of organization they are (i.e. small business, large place-based business, etc.). The scorecard could also potentially be a way to measure the progress of these programs. However, the group also agreed that the scorecard needs to be modifiable based on evidence to ensure programs created are not a waste of resources.
Participants left the Aspen Ideas Incubator event and Aspen Ideas: Health with determination that they will carry out the ideas formed throughout the week. Participants agree that innovative thinking, unlikely partnerships, and increased collaborations will be critical to uncovering new solutions to address the social determinants of health.