The new era of population health: Digital therapeutics for mental health

Fifteen years ago, I began my journey in population health, working to improve policies, systems, and community environments that drive health and well-being at scale. Back then, the public health adage — your ZIP code is often a stronger predictor of your health than your genetic code — was still a relatively new concept to the general public.

As a leader of community-based philanthropy and population health practices, I worked across sectors and deep in communities with nonprofit organizations, local governments, school systems, and others to demonstrate how we can improve health by engaging communities outside of a medical setting. After all, we were discovering that social factors – where people live, learn, play, work, and worship – contribute to more than 80% of health outcomes, while medical care only accounts for between 10% and 20% of our overall well-being. Through these findings, and the efforts of population health practitioners globally, we now have a better understanding of how good health is produced, and how societal inequities prevent many people from achieving optimal health and well-being.

The pandemic further shifted our view of population health. We quickly learned how vulnerable our communities are – across U.S. ZIP Codes, and around the world. We saw populations, largely Black and Brown, get sicker and die at higher rates than others. Inequities and injustice toward communities of color were amplified by the lack of access to information, COVID-19 testing, and eventually, vaccinations, in these communities. Throughout the pandemic, we were forced to reckon with the historic divisions and inequalities in our healthcare and other systems that foster disparities in health and life outcomes for too many.

There is talk of our society experiencing a triple pandemic over the past two years, which references the simultaneous health, economic, and social justice impacts of COVID-19. Unfortunately, we are now seeing a fourth leg emerge. Over the past 18-months, 4 in 10 adults in the U.S. have reported symptoms of anxiety or depression, which is up significantly from 2019. All indications show that the mental health impact of the pandemic will sustain for years to come, posing another significant threat to global health.

Today, I am proud to share that I have joined Big Health as Vice President of Equity & Population Health to help address the global mental health crisis directly.

Equity and mission go hand-in-hand

In April 2021, Big Health co-founders Peter Hames and Professor Colin Espie made a formal long-term commitment to increasing mental health equity. The Big Health team recognizes that we cannot achieve our mission of helping millions back to good mental health without addressing inequities in the provision of mental healthcare.

Although the prevalence of mental health conditions are at an all time high, approximately 60% of adults with a mental health condition do not receive any treatment, and people of color are disproportionately impacted. For those who do receive care, the experience is far from equitable. Black people are more likely to be misdiagnosed with schizophrenia and other high acuity mental health conditions compared to white counterparts with similar symptoms. In addition, people of color are more likely to have mental health concerns addressed in primary care or in the emergency room, without access to therapy or mental health specialists.

Because digital therapeutics provide evidence-based care, including cognitive behavioral therapy, through a pure software solution, they effectively scale access to clinical support without coaches or clinicians. This innovative care delivery model allows us to reach individuals who otherwise wouldn’t have access to treatment. When created and implemented thoughtfully through a stepped care model, digital therapeutics provide a consistent and equitable experience for users, avoiding biases that often occur in traditional mental health treatment.

Making good on our promises

As part of Big Health’s commitment to increasing mental health equity, the team developed three specific goals addressing our internal structures and external impact.

1. People: building a diverse team & equitable systems
2. Product: ensuring our therapeutics are inclusive
3. Populations: reaching & supporting those who are underserved

Recognizing that these three goals require ongoing company-wide effort and committed oversight, the team created my role, Vice President of Equity & Population Health, and I am proud to serve on the executive leadership team to support company decision making while ensuring progress across these three goals and other key priorities across the business.

While I am excited to share that Big Health will begin issuing our bi-annual equity scorecard and report in 2022, I wanted to provide one update that I believe best represents the team’s progress, our commitment to improving internal structures, and focus on continual improvement.

Today, 38% of Big Health’s leadership team consists of women or underrepresented minorities. Although we are still shy of our long-term ambition of having the diversity of our workforce reflect that of our user base, I am encouraged by the team’s progress to date. However, we must continue improving diversity and inclusion at Big Health to ensure that Black, Latinx and LGBTQ+ communities among others are better represented within our employee base.

The new era of population health

Ultimately, my role at Big Health is to ensure that millions of people have access to evidence-based mental health care that delivers equitable outcomes regardless of ZIP Code, race, or economic status. I will be integrally involved in Big Health’s product development, go-to-market strategies, and business operations to ensure we bring an equity mindset to all that we do to scale access to good mental health.

Having spent much of my career focused on serving populations that have been marginalized and helping create conditions for better health, I believe that digital therapeutics are poised to improve global health practices in the future. By scaling equitable access to digital therapeutics, we can address the mental health crisis in ways that weren’t previously possible. I am incredibly energized by the opportunity to support what I consider to be the new era of global population health.

Disclaimer: In accordance with FDA’s Current Enforcement Discretion Policy for Digital Health Devices for Psychiatric Disorders, for patients aged 18 years and older, who are followed by and diagnosed with Insomnia Disorder or Generalized Anxiety Disorder by a medical provider, Sleepio and Daylight can be made available as an adjunct to their usual medical care for Insomnia Disorder or Generalized Anxiety Disorder, respectively. Sleepio and Daylight do not replace the care of a medical provider or the patient’s medication. Sleepio and Daylight have not been cleared by the U.S. Food and Drug Administration (FDA) for these indications.