Yesterday I read a colleague’s post about racism on LinkedIn and noticed that someone in the comments, a white man, told her, a woman of color, that LinkedIn is a professional site, and not the right platform to talk about racism. Every platform is the right platform to talk about racism. And those of us with privilege need to step up and use our platforms to speak out against systemic racism.

The day before, I had tried to do just that. Savvy Cooperative was part of the 2020 MassChallenge HealthTech cohort that ran January to June. On Wednesday June 3, 2020, the startups gave their final pitches. In light of current events, it felt inappropriate to not acknowledge the crisis at hand and use our platform as a means to discuss what matters, that Black lives matter.

If the pitches were in-person, I could have stepped aside and yielded my time to a Black founder to restore some equity. But in this virtual world with a predetermined 15-minute Zoom time slot, I chose to use the pitch, platform, and privilege afforded to me to talk about racism.

I have given countless pitches — we are actually somewhat of pros at pitch competitions. But for the first time in a long time, I was really nervous. I was Trojan-horsing what was supposed to be a rehearsed product pitch and instead talking about racism in healthcare to the predominately white healthcare executives who were serving as judges. I felt nervous and worried that I would say something wrong, but I felt worse thinking about remaining silent.

While my momentary anxiety was unpleasant, it is absolutely nothing compared to the daily anxiety and injustice of living with black skin in our country. I recognized my privilege, leaned into my discomfort, and gave the following presentation.

 

Since I have a captive audience, I’d like to spend my time with you today to talk about racism. Because the truth is, we can’t talk about health equity if we don’t highlight that racism is a public health crisis.

Many Black people have high levels of mistrust for the healthcare system, which is a result of, or leads to, some of the following documented inequities and disparities in Black communities:

 

Savvy is a co-op, meaning we are collectively owned by our community members. We organized this way because we believe that if we want to create a more equitable future, we need to start by giving people equity and a voice in our business.

That’s why we cannot and will not ignore our Black and Brown community. So rather than show you a product demo, I’d like to teach you about Savvy Cooperative and who we are by sharing our statement from Monday, June 1, 2020:

We started Savvy Cooperative because of a deep discomfort that we — as leaders in our respective communities — were being asked to speak on behalf of all other patients with our conditions. There is no way, no matter how woke or empathetic we strive to be, that we could ever fully understand the experiences of people with different backgrounds, privilege, circumstance, and skin color.

While our work is centered around healthcare, we know that health extends into every part of someone’s life. Health affects one’s work, family, and overall safety, and these areas have an impact back on one’s health. That’s why institutional racism is a public health crisis.

New technologies and treatments alone won’t improve health outcomes for people of color. If they did, we wouldn’t see algorithms recommending better care for white patients than Black patients, inadequate treatment of pain in Black patients, and Black Americans dying from COVID-19 at a rate 3.57x higher than white Americans. We must do better to understand health disparities and inequities if we want to truly change course.

At Savvy, we are committed to do our part to improve health outcomes for people of color. One of our Core Values is to “Champion Inclusivity.” We strive to do this every day. It is something that comes up on almost every client call, which is a clear signal that the work is far from done. ‪We recognize that we still have miles to go, but you have our commitment to not let complacency or difficulty stand in our way of improving.

As leaders, we recognize that we don’t personally have all the answers and need to make space to listen to others who have been silenced and ignored. We see you, and promise to amplify your voice and work with you to be part of the solution. The future of healthcare is co-designed with patients, which — to be very clear — must include patients of color.

In humility and cooperation,

Jen & Ronnie

Founders, Savvy Cooperative

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Many are making statements over the current events, but are they actually doing anything about it? While we have not solved the problem of racism, inclusivity in healthcare product development is exactly why Savvy even exists.

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For too long there has been a disconnect between the people who make products and services, and those who are intended to use them. We then call patients non-compliant, but we haven’t done the work to understand their needs and unique circumstances.

Why do we keep missing the mark? Just consider our current startup cohort. If we have the courage to look closer, we’ll see it is a bunch of people who mostly look the same, guessing about the needs of certain communities that they don’t belong to.

This doesn’t make them bad people or lousy technologists, just ill-equipped to create inclusive solutions without outside help.

 

That’s why Savvy provides a marketplace for patient insights, where companies can connect directly with diverse patients for the purpose of user experience and market research. So they can learn about the needs and priorities of the communities they wish to serve.

This has never been more important than in the last 6 months. The world is changing. While most companies scaled back, we doubled down to make sure innovators didn’t sacrifice understanding how these changes are impacting the communities they serve.

In that time, we have subsidized 30 projects to ensure innovators continue to get diverse insights. And since patients get paid for the insights they provide to companies, we have helped even more patients earn additional income during this economic downturn. This also gives a voice to patients, many who have a lifetime of experience with social distancing and sheltering in place because of their health conditions. They are now finally being turned to as experts during this critical time.

Savvy made history in March as the first co-op to ever receive venture capital. I join the ranks of the women who make up less than 3% of venture funding, but Black founders still only make up just 1%. We must do better.

I recognize I have gone over the suggested 5 minutes and have been speaking to you now for 6 minutes and 14 seconds. But I want to acknowledge that this is still less time than George Floyd was pinned down by a police officer with a knee on his throat, and could be heard saying “I can’t breathe” 16 times before he died as a result of police brutality.

Racism is the knee on the throat of people of color. It results in COVID-19 being called the “Chinese virus,” Muslims being targeted as terrorists, and Black people being profiled by the police. All of which affect someone’s health and well-being.

These are experiences that I as a white woman could not begin to comprehend.

So while I cannot say that we at Savvy have meaningfully solved this, I know we are committed to being part of the solution.

That’s why I don’t need your award today, because my real reward is knowing that we are impacting the lives of those who have not been seen, like Diane — who shared this after she received our statement on Monday — and the thousands of patients we have worked with since we began.

 

I hope as you evaluate startups today and in the future, you’ll be sure to ask if they are doing the work to create more inclusive innovations. The future of healthcare is co-designed with patients, which — again, to be very clear — must include Black and Brown patients.

Thank you for your time.

References and readings

• Racism, Inequality, and Health Care for African Americans. The Century Foundation.
• Implicit Bias and Racial Disparities in Health Care. The American Bar Association.
• Race and Medicine: The Harm That Comes From Mistrust. The New York Times.
• Myths about physical racial differences were used to justify slavery — and are still believed by doctors today. The New York Times.
• How we fail Black patients in pain. Association of American Medical Colleges.
• Millions of black people affected by racial bias in health-care algorithms. Nature.
• African American women with breast cancer less likely to have newer, recommended surgical procedure. MD Anderson.
• Black Patients Miss Out On Promising Cancer Drugs. ProPublica.
• Women and Black patients are poorly represented in clinical trials, analysis finds. STAT News.
• Black Participants Are Sorely Absent from Medical Research. Leapsmag.
• The Trauma Of Being Black In America. NPR.
• Research Shows Entire Black Communities Suffer Trauma After Police Shootings. Yes! Media.
• Aggressive Policing and the Mental Health of Young Urban Men. American Journal of Public Health.
• Police, Equity, and Child Health. American Academy of Pediatrics.
• Infant Mortality and African Americans. U.S. Department of Health and Human Services.
• Why America’s Black Mothers and Babies Are in a Life-or-Death Crisis. New York Times.
• Diabetes and African Americans. U.S. Department of Health and Human Services.
• Heart Disease and African Americans. U.S. Department of Health and Human Services.
• The Black American Amputation Epidemic. ProPublica.
• What’s Behind the COVID-19 Racial Disparity? The Atlantic.
• Police killing black people is a pandemic, too. Washington Post.
• Genetics is not why more BAME people die of coronavirus: structural racism is. The Guardian.
• How Racism Kills Black Americans: The health effects of discrimination are usually less obvious than murder. The Atlantic.

Jen Horonjeff, PhD, is the Founder & CEO of Savvy Cooperative, a patient-owned public benefit co-op that helps healthcare companies understand the needs of diverse communities by providing a gig economy marketplace for clinical, user-experience and market research. Jen was named one of the 50 Most Daring Entrepreneurs of 2018 by Entrepreneur magazine for Savvy’s innovative model that both empowers patients and equitably values their contributions.