Why We Launched a Health Equity Moonshot

Led by KP Yelpaala, global entrepreneur and health equity expert, our new Health Equity Moonshot will focus on building a framework for investing in under-represented founders and serving communities that have been historically left on the margins. We sat down with Yelpaala to get his vision for a Health Equity Moonshot and why it is necessary today.

StartUp Health is excited to announce a new Health Equity Moonshot. Led by Kaakpema “KP” Yelpaala, CEO and Co-founder of InOn Health, this endeavor will focus on building a framework for investing in under-represented founders and serving communities that have been historically left on the margins.

Yelpaala is a long-time Health Transformer with StartUp Health. His background and experience with InOn Health, a platform that works to improve patient outcomes for diverse communities through improved communication, will bring invaluable knowledge to the Health Equity Moonshot.

Q&A

Over the last couple of years, we’ve heard plenty in the news about corporations ostensibly focusing on health equity. You could argue there’s been more words than action. What is your vision for the Health Equity Moonshot, and why is it necessary for a new initiative right now?

Yelpaala: Through the COVID-19 pandemic, we saw the disproportionate burden of mortality and morbidity in populations of color and other minoritized people. That was the trigger to bring this discussion back into the mainstream conversation. Health disparities and health inequities have existed for decades. So that’s not new. But the pandemic shined a light on it in a way that galvanized people. Something has to change.

When we think about where we go from here, the innovation ecosystem is a big part of that. Many founders from minoritized backgrounds — people of color, Black, Latinx, indigenous, and women — are doing the work. Not only building innovative companies but also trying to build solutions to solve the challenges you find that drive those health disparities. We have a disproportionate burden of disease and mortality in those pockets.

If you take Black, Latinx, indigenous people of color, and women collectively, that represents 70% of the US population. However, founders from those backgrounds receive less than 10% of new venture funding. And if we look at the funds making these investments, the same pockets of people I talked about manage around 1.3% of those dollars being invested. So, we’re running into the brutal truth that we do not have enough investment going into minoritized founders and women. We don’t have enough companies breaking through from pre-seed, seed, and Series A to scale solutions for these populations. That’s the heart of the matter. There’s a lot behind it, but that’s what we’re really looking to get into.

There is a substantial distinction between word and deed when it comes to health equity. How do you think about moving towards real action on this issue?

Yelpaala: Many organizations have made commitments to equity. Many of us watched to see if these commitments were just words or if more was going to happen. Unfortunately, if you look at where we are today, many of those commitments that people made haven’t moved forward and made any substantive moves beyond the words. This is the truth.

There are three layers that I’d like to frame: words, intention, and action. When I approached StartUp Health’s leadership, I had a very open conversation saying that not just I, as a founder of color, but other founders of color and women, have been having challenges raising rounds pre-seed to seed, having challenges that we think are related to our backgrounds. Every entrepreneur has challenges. Starting a company is hard. No one’s saying that’s not the case. But there are layers upon layers of other issues that minoritized or historically marginalized populations face. We’re really looking for who will step up and lead and have the right intention.

So, we’re not saying that everything has to be perfect today, but if we can partner with groups in the right way and set the right intentions and make them public so that we’re accountable, then show how we’re moving towards those actions, that’s how we build trust. Ultimately, we’ve got a breach of trust for many people who don’t think there’s an intention to support historically minoritized, marginalized founders.

Another important dichotomy on the issue of equity is micro versus macro. What is the responsibility of the individual and the startup compared with legacy institutions?

Yelpaala: Right. When you look at corporations, ventures, and all of that, part of this gets missed. Sometimes we say there needs to be more funding for founders of color, people of color, indigenous populations, and others. And the issue is, who are the LPs funding the funds if you go upstream? You need diversity throughout the chain. In other words, the LPs investing in these funds must come from more diverse backgrounds. That will impact the theory of change and thesis of those investment funds and how they analyze companies.

Then, when you look at how those funds are deployed, we have to understand that there needs to be a certain amount of intentionality around supporting and engaging underrepresented founders. Sometimes we have to talk about that upstream. Downstream, there’s no shortage of these founders. They’re there. But I think founders of color are becoming savvier to really sizing up whether some of these investment funds are there to back them, be empathetic, and work with them through the unique challenges they’re going to face to build their businesses. Those are all different layers of the onion that we hope this initiative unpacks.

What I hear you describe is more of a holistic, 360-degree support for a founder versus a single initiative. It’s about more than money.

Yelpaala: Exactly. There needs to be a 360-degree approach. When I came to StartUp Health to have this open and honest conversation about my own struggles and what I was hearing from my colleagues, I appreciated that I felt heard. They listened. I felt like they believed what I was saying. They were like, yes, we’re actually hearing this from other founders. And when you look at StartUp Health’s model, on the one hand, we’re talking about funding. There needs to be more funding, but not just that. Someone needs to lead the round. A lot of what these founders face is they can’t find a lead investor, but they have plenty of investors that say they will follow. That is a challenge for entrepreneurs generally, but it’s more of a challenge for founders of color and women. But if you go and run the numbers, you’ll find that founders of color, relative to other founders, have a harder time finding a lead. So we need venture to step up and lead early. That will create the successes that will get companies to Series A and B. And StartUp Health is in a position with intentionality to implement dollars that way.

We also need community. We can use The StartUp Health Festivals to create a space on an ongoing basis — not on a one-off — for founders to share their stories and successes and to connect. And then the issue is, how do we track this over time and create accountability? I think StartUp Health, as a leader, is setting an intention and saying we know that we want to move to a better place.

Look, 30% of StartUp Health founders are women or people of color. That’s pretty strong. But we also know that has to cascade through the board, the LPs, all these other elements of the model, and even in our [Health Transformer] Circles. When we think about the Circles we bring together of entrepreneurs, how do we create spaces for diverse founders also to be able to connect and have a support system? So it is truly a 360-degree approach that we’re considering.

It makes one think about social determinants of health (SoDH) and how you can’t just hand somebody a pill if they’re having trouble. They don’t have a car. They don’t have a way of getting an education. All these things contribute to health that have nothing to do with the treatment and therapy that you think is the cure, this wraparound approach to health. When you think about the wraparound approach to supporting entrepreneurs from traditionally marginalized backgrounds, what other ways can we help beyond funding? What are some of the creative ways that we can offer holistic support?

Yelpaala: The information about these challenges needs to be out there and more public. A number of industry reports are coming out and showing that these things are the case. So, how do we build more awareness that this is true? Because the fact of the matter is, not everyone believes this is true. Some people will say it’s just hard for entrepreneurs. That’s just life. Every entrepreneur is struggling. And so, the industry needs to accept that it is harder for minoritized founders and women, period.

The issue, too, is if we can lead early and understand that those unique challenges translate into different things. Women and minoritized founders might need more runway to get to that next round because they face other challenges. So, when we start to accept that intentionally, we build a model wrapped around those unique challenges and will also enable these entrepreneurs to be more likely to succeed and get to that Series A / Series B.

StartUp Health is very much about health transformations. The unique stresses of being an entrepreneur who’s a woman or minoritized add dimensions and layers to that. And so, when we think about communities and [Health Transformer] Circles that StartUp Health organizes for entrepreneurs, peer-to-peer networks, and groups, there’s an intentional model that can be built around that. You’ve got the support systems around the entrepreneurs, you’ve got building the stories of these entrepreneurs and the unique challenges they face, and then funding them early and leading to give them a chance to get through those early hurdles and move to their Series A, B, and C.

Two themes I’m hearing coming out here are clarity and empathy. So transparency, really being able to walk through your experience as a Black man in America — here’s what I came up against, here were the challenges that I faced, and then having groups that can really enter into that with empathy and say, you know what, I may not have experienced that myself, but I hear you. I’m right there with you. And using that as a foundation to start, like you said, creating the intentionality for what we do next together.

Yelpaala: That’s 100% right in my view. Empathy is a clear part of this. Because I’ll repeat it, entrepreneurship is hard for every entrepreneur. It is. A study from Rock Health in 2020 said that less than 30% of Black digital health founders were venture-backed compared to 50% of Asian and white founders. It’s just the truth. So, we’re not trying to minimize the challenges entrepreneurs face in the market. We’re saying there’s a unique set of challenges that this type of entrepreneur meets that must be addressed so that this country, this innovation ecosystem, can benefit from the brilliance of these people. Because those innovations will help unlock some of these intractable challenges out there that these transformers are working on.

Another contrast that stuck out to me was short-term versus long-term. There are specific issues around health equity that we can discuss, be intentional about, then evolve and strategize to improve. And there are some things where we can say we’ve had enough, and this needs to change today.

Yelpaala: Health equity is an aspiration. It’s about everybody achieving their fullest health potential, which is a long-term bet. We work in healthcare. We know everything is long. Anyone in healthcare knows that. We’re talking about the tactics like you’re saying, both short-term tactics and intentionality. Part of this is also the work we do inside our organizations, like that StartUp Health is willing to partner with me and others to start to do the job. We got to do that internal work as an organization, which translates into how we work with entrepreneurs. Those are some of the short-term tactics and intentionality that move us towards that longer-term aspiration of health equity.

I understand you’re collaborating with the Clinton Global Initiative and have an application with them. What does that look like with CGI?

Yelpaala: The Clinton Global Initiative is restarting after several years. And their goal is to partner with the public and private sectors around commitments to action that can be transformative in terms of social and economic welfare. One of their tracks is around health equity in the US, understanding our tremendous challenges.

We will be participating in StartUp Health and being public about some elements of how I will be working with StartUp Health and others to fulfill not just the Health Equity Moonshot but really looking at how health equity infuses all the moonshots and everything that the Health Transformers are doing, how we think about that in the US first, but then eventually, how we think about that globally.

We’re very excited to be participating in the Clinton Global Initiative. More to come on that, but our real intention here is to make the first volley to say, we’re here, we’re acknowledging that this needs to happen, we’re being intentional about it, and we’re going to be public and accountable to change. And all those things send the right signals to the market to build trust and to show them that we’re going to do something.

You mentioned something key: this is not a separate moonshot initiative. Health Equity Moonshot is a framework woven throughout every initiative StartUp Health does, and we will have to build it in different ways. I hear you saying it will have to be a language, a system, and a filter by which we think about the entrepreneurs that we back, the systems that we create, and the language we use.

Yelpaala: Precisely. And in our governance, our impact boards, to ensure we get appropriate representation there. It will ensure that we intentionally infuse this throughout the system and have a plan. I’m very, very pleased, and this is what it takes. The fact that I went to StartUp Health leadership and had this conversation and they’re willing to take action and collaborate is what it takes. It’s real work. There’s no silver bullet, but we’re on our way. This is the first step, and I’m glad.

In many situations like this, there’s so much that has happened that we can celebrate, yet there’s so far we have to go. You alluded a minute ago that there is untapped potential within this underfunded group of founders waiting to be unleashed on the world’s most significant health challenges. Could you speak to that briefly?

Yelpaala: Yeah, there’s a lot of frustration. Indeed, indeed. But action is essential. Accountability is important. Sharing these stories and having empathetic and open communication is vital. We’re having this conversation, and StartUp Health is willing to make this move intentionally. We need to see more of that. The frustration is that these founders are still running into barriers left, right, and center, and we’re not fulfilling our fullest potential in an innovation ecosystem. Again, this is the long-term work that builds on the successes of entrepreneurs who are getting it done and on the achievements of the new funds coming out through it. We need more intentionality, and we will build on all that.

But the frustration is still indisputable because health equity and these inequities are about people’s lives. So for those of us that are diverse founders, minoritized, women, we know people who have died because of these things. We go through our stuff because of this. It’s personal. That frustration is deeply personal because it impacts our lives and our lives as founders. That frustration turns into collective action, and we’re looking for the right platforms to drive the intentional systemic change.

And if we can tap into that, as I said before, we unleash the talent that has been missed.

Yelpaala: And unseen, wholly unseen and uninvested in.

And that talent is precisely what we need.

Yelpaala: And an example that others can look at. So the idea is that StartUp Health should be part of an ecosystem of actors doing this across the country, and we need leadership. I’m happy StartUp Health is willing to get in the game.

Want to join this Health Equity Moonshot? If you’re an investor who believes in this vision, we want to hear from you. Are you a founder focused on breaking down health barriers for historically marginalized communities or who has been held back based on systemic bias in race, ethnicity, gender, or sexual orientation? We want to hear from you.

KP Yelpaala Shares the Mission & Vision Behind StartUp Health’s Health Equity Moonshot

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KP Yelpaala Shares the Mission & Vision Behind StartUp Health’s Health Equity Moonshot

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Why We Launched a Health Equity Moonshot was originally published in StartUp Health on Medium, where people are continuing the conversation by highlighting and responding to this story.

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