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I’m scheduled to get my first dose of the Pfizer-BioNTech COVID-19 vaccine at 3:00pm tomorrow. Given the number of people that have taken the vaccine to date, I am often asked why I have not taken one until now. The answer is that I am in a largely fortunate group. I am healthy with no pre-existing conditions or chronic diseases, am younger than 65 and also am not considered a frontline worker. I have a few thoughts on fellow perfectly healthy individuals who have taken advantage of loopholes to get vaccines in advance of California’s new eligibility guidelines but our time today is much better spent elsewhere. As someone who will be considered “fully vaccinated” by May 24th (15 days after my second dose), I am already daydreaming about the travel I’ll be embarking on, friends and family members I’ll see and exciting new areas of my post-pandemic social life. I won’t share those details today either. Instead, in light of the importance of vaccines and a highly functional healthcare system, I’ll share some of the healthcare investing themes I’m excited about most.
1. Virtual and TeleHealth for the Care Avoidant
I spoke with a young woman last week who happens to be an immigrant to the US. She shared that as a woman in her conservative immigrant community, both mental and sexual health are taboo subjects. For that reason, many individuals in this community and others like it are care avoidant (a term typically used to describe individuals who avoid professional healthcare in spite of a preexisting conditions) in these and other areas. Interestingly enough, care avoidant individuals are typically stereotyped and assumed to be low-income and elderly but what I learned during our conversation is that there exists large swaths of these individuals who are young, educated and have disposable income, many of whom are living, learning and working on US college campuses, in large US corporations and in highly populated US communities. This offers a unique opportunity to entrepreneurs and healthcare providers that are able to address these needs with innovative approaches allowing for anonymity in receiving healthcare guidance or advice, care through a “culturally competent” lens, and / or engagement with providers who share a common identity. Let’s look at the market opportunity. Immigrants and their U.S.-born children account for ~30% of the US population or more than 85mn individuals. In 2019, the average healthcare spend per individual in the US was $10,966. If we account for just 30% of the 85mn mentioned above, you reach a total addressable market of $279bn. That’s sizable and does not include groups in the US who avoid care based on religion, stigma, or other limitations. There are careful nuances in this category to consider like provider availability and internet access that I don’t claim to have deep expertise in but the opportunity itself is one I remain excited about.
2. Maternal Health
Last week, April 11th through April 17th, was Black Maternal Health Week, an initiative bringing awareness to the fact that Black women are three to four times as likely to die during child birth than White women in the US and Black (which includes mixed race) babies are more than two times as likely to die before their first birthday. The statistics, particularly in a country considered to have the best medical care in the world, are staggering. As a Black woman, this topic is meaningful to me personally. As an investor with insight that there are more than 500mn Black babies (not including those of Hispanic descent) born each year to more than five hundred million women, the implications are hard to miss. Minority groups in the US drive our economy and contribute a significant amount to annual GDP. As a country, we simply cannot afford the — often preventable — loss of Black life, morally or economically.
3. Preventative Healthcare and Wellness
Up to 40% of the leading causes of death are preventable. That statistic is from 2014. While more recent data is scarce, the 2020 data on preventative causes of death reveals that more than 50% are attributed to medical errors, tobacco use, obesity, alcohol and infectious diseases. This means, activities as simple as maintaining a healthy diet and exercise regimen, washing hands, avoiding cigarettes and alcohol and maintaining clerical accuracy can significantly reduce the chance of death in otherwise healthy individuals. As a country, we’ve long been aware that its more cost-effective to prevent disease than to treat it. Unfortunately, our investment dollars haven’t caught up yet. In spite of being a value conscious consumer, I personally don’t self-impose restrictions when it comes to wellness-based activities or preventative healthcare which includes everything from gym memberships to organic fruit for precisely this reason. Given the value of the fitness industry and Whole Foods, very little research is needed to know the extent to which other consumers are prepared to make the same allowances. In fact, the numbers themselves confirm they do. In spite of this, healthcare continues to rise. My hunch is that this is largely driven by the fact that preventative health measures are often taken by people who are least likely to be exposed to negative health determinants and outcomes. My hope is that more founders find ways to make these measures more accessible.
Never before in our living history has the fragility of our health and healthcare system been so palpable. For me, it’s what keeps me stocked up on antibacterial hand soap, refreshing multiple websites at once to find a nearby vaccine appointment and walking a mile each way to a group fitness class on a sunny San Francisco Sunday afternoon. I’m very interested in its impact on you.
Off I go now. See you in blog post #16.