Forms of Wisdom: Lessons from Public Health Entrepreneurs

Coming from a public health background myself, the intention of the class is to provide a framework for utilizing entrepreneurial pathways to achieve public health goals. My own public health training was largely about analyzing problems and less about envisioning, creating, and implementing solutions. I wanted public health students to have that training, as well as MBA students at the School of Management.

They may not think of themselves as public health people, but in whatever job they have after graduating, they will in one way or another have an impact on what we call drivers of health: the social and environmental factors that determine health outcomes. That’s really what the course focuses on. How do racism, sexism, income, employment, environment, pollution, housing, transportation—all of the different factors that make up our world—impact health outcomes?

How does your podcast Impact & Innovation fit in?

We use the case method to discuss public health entrepreneurship and intrapreneurship and extrapreneurship initiatives, and to think about some of the challenges and some of the patterns that we see. The framework for the course is a peer-reviewed journal article I wrote called Towards an Understanding of Public Health Entrepreneurship. It talks about design thinking, resource mobilization, financial viability, cross-sectoral collaboration, and system strengthening. We analyze these cases using that framework.

An underlying theme that always comes up in this class is that design thinking and innovation are not enough. We want innovators to apply design thinking, not in an extractive way, but to build power for others. The words that Ashlee Wisdom, the founder of Health In Her HUE, used when speaking in the class—which I’ve been using since then—are “design justice.” How can you make sure what you’re doing is design justice, where you’re thinking about questions like: Who’s experiencing this problem? How can you get resources into their hands and let the solution be driven by them in a way that builds power and wealth for them?

We use the case method to analyze examples of public health entrepreneurship and intrapreneurship, and sometimes we have the opportunity to bring in case protagonists. It’s not always the case that we can have the protagonist actually with us in class, but when it happens, it leaves such a huge impact on the students and also on the guest entrepreneur because they have this opportunity to reflect on their experience and to discuss with students. They usually go home feeling like they have a bunch of new ideas and are reinvigorated to do the work.

This spring there were four guests that visited my class. After class we went down to the studio and debriefed on what we had discussed in class for the podcast. All four of them were women of color who are working on public health entrepreneurship. For me, there were so many insights that came out from the wisdom that they shared and from their self-reflection. Over the course of the semester, their lessons intertwined and really built on each other.

Tell us something you learned from each of your guests.

Daisy Rosales ’20 was my mentee in the Startup Founders Practicum at SOM. She started a global mental health nonprofit called Brio that partners with community-based organizations to innovate new programs, pilot them, and help them scale.

One insight that came out of my conversation with her was that all humans suffer and each person’s own lived experience can inform the way they connect with a person from a very different background and with very different experiences. We talked about standing in solidarity with someone and being able to say, “I know your pain is different from my pain, but that doesn’t mean we can’t stand in solidarity.” She shared with me a quote from an aboriginal leader in Australia named Lila Watson, who attributes this quote to a group of activists: “If you have come here to help me, you are wasting your time. But if you have come because your liberation is bound up with mine, then let us work together.”

That’s the approach that Daisy takes to her work. She’s not trying to be a Yale MBA savior who’s going into low-income communities in low-income countries. She’s just asking the question, “How can we all thrive and how can we all work together?”

Ashlee Wisdom has a master’s of public health from NYU, and her lived experience, as a Black woman seeking healthcare, led her to realize that one of the reasons that Black women have poor health outcomes—and the data shows that Black women have among the poorest health outcomes in the U.S.—is that they don’t receive culturally responsive care. A lot of people are talking about the lack of trust between Black people and the U.S. healthcare system. But they talk about it as if it’s the lack of trust itself that’s the problem, not the root causes and events that led to that lack of trust.

Ashlee’s company Health In Her HUE is a for-profit company—she’s raising venture capital funding—that aims to help Black women find providers who look like them and other culturally responsive providers. Not all the healthcare providers have to be Black women, but they have to be culturally responsive and think about what it means to be a Black woman: what is this patient experiencing that might be related to their health outcomes?

Ashlee herself had gone to see a physician for stress hives when she was working in a toxic work environment and facing microaggressions related to racism and sexism, and her healthcare provider never had that conversation with her that would’ve helped get to the root causes. They just sent her for a bunch of really expensive tests and nothing came of it. Ashlee spent a bunch of money and the hives didn’t go away until she left her job.

She started Health In Her HUE to help more Black women feel that they can connect with culturally responsive providers that they can have those conversations with.

I would call Brita Roy an intrapreneur and an extrapreneur. She didn’t start a new organization; she innovated within an existing institution, at Yale. But more importantly, she started a new venture that had multiple parties in it. That’s why we call it extrapreneurship, because she innovated across the boundaries of multiple institutions. She partnered with the Urban League of Southern Connecticut and the SEICHE Center for Health and Justice at Yale and with other community partners to launch a new initiative called TRUE-HAVEN, which stands for Trusted Residents and Housing Assistance to Decrease Violence Exposure in New Haven. Some of their trusted community partners are just people in the community, not necessarily healthcare workers or people related to Yale. For example, they have a network of barbershops that they work with.

They applied systems thinking, which means thinking about gun violence as part of one or more entrenched systems that propagate the problem; understanding how those systems work; thinking about root causes and the interconnectedness of factors. With the partners they had been working with in the community for more than 10 years, they did an exercise to map out the systems that gun violence perpetuates in.

The intervention they ended up designing was actually about the last thing you’d expect: housing. They started thinking about how to create communities with a strong social fabric, communities that people can live in and thrive in, because that is a key requirement for reducing gun violence. TRUE-HAVEN has many components: the community partners in New Haven work together to provide housing for formerly incarcerated people; they provide financial literacy; and then they also train trusted community members in trauma-informed counseling.

The story of TRUE-HAVEN really showed the importance of looking at root causes when you’re designing a social innovation, of working across sectors and bringing together a coalition of community partners—and of thinking about the system that allows social challenges to perpetuate.

The last podcast I recorded this spring was with Song Kim ’20, a former student who took my SOM course, Social Entrepreneurship Lab. Song is a civil rights lawyer. Before coming to SOM, she was working as a lawyer defending workers’ rights, and she came to SOM to figure out some kind of career transition. While she was taking my course, she connected with someone else at Yale who was working on a medical device startup. They asked her to join the team and she came on board as the chief operating officer.

The company is called KovaDx, and they are removing barriers to quality care through point-of-care blood monitoring. They’re starting with sickle cell disease, which disproportionately affects people of color. Their solution allows for ongoing monitoring and preventative care for individuals with sickle cell and other rare blood diseases.

We talked about her journey into entrepreneurship after being trained in law, transitioning to her current role as CEO, and navigating that journey as a woman of color. People perceive CEOs to have certain qualities— most CEOs are White males—and she had to really step up, find her voice, and find a way for the existing team to realize that it really made more sense for her to take the helm and transition to being CEO. We talked about those social and cultural factors that women are raised with and the perceptions and biases that their teammates have about what their role should be and how she has navigated that.

Would you talk about some of the larger lessons that social entrepreneurs can learn from these conversations?

I was blown away by these women: their grace, their humility, their leadership, their brains, and their abilities, and by the commonalities of what it took for them to really step into the roles that they really need to play in order for us to see any changes in the societal problems that they’re tackling. Each one of them has changed the perception of what it means to be an entrepreneur, to be a changemaker, to be a leader, and each one of them is bringing her own lived experience into that.

One of the things I’m hoping the podcast can do is shine light not only on some of the social entrepreneurship that’s happening—for people to learn about solutions and pioneers and innovations—but also to think about how being a leader of change doesn’t always have to look like one thing. There are many different approaches to leading social change, to social innovation and entrepreneurship, and it’s going to look different for each person.

One of the overarching themes of this work was that each person has to ask themselves not only what social change they are looking to contribute to and what kind of intervention or program or product they are looking to design, but also what their path is to being part of social change. How can I bring my own lived, learned, and work experience and into that work?

When these amazing people take the time to come speak with my students and me, I want to share their stories beyond just these 50 or 100 students; I want to share their stories with the world. There are so many people out there thinking about drivers of health, public health outcomes, and other social and environmental challenges. It’s so important for them to be part of the conversation and know what we’re talking about behind these walls.

We learned so much this semester from these four amazing women about understanding your own leadership style, how to connect with the community you’re serving, how to build power for them, and what it looks like for both them and you to flourish. I think everyone, whether they’re trying to start a social enterprise or trying to make a difference in an existing job, can have something to take away from these conversations.