Time to ask tough questions about impact of our investments

A year ago, I co-led a Reinventure Capital workshop for retail and institutional investors modeled after the popular “Choose Your Own Adventure” children’s books.

The 90-minute exercise led participants through a decision tree that explored how they could shift capital to serve the positive impacts they wanted to see in the world. After completing the exercise, an attendee wondered aloud, “Why haven’t we been doing this all along? Why don’t we move money quicker to more positive investments?”

The answers to her questions may be complex, but she nailed a key point: The status quo is not inevitable; we can make different choices.

Whether we are venture capitalists or employees with retirement accounts, looking critically at the decision patterns governing how money is invested and deployed allows us to more clearly visualize the impacts of these investments and tweak strategies accordingly.

At my organization, Rhia Ventures, we leverage capital to inject health equity into a health care system that produces disparate outcomes based on race, gender, zip code and other social factors. Through field-building, direct investment via RH Capital, corporate engagement and narrative-change work, Rhia seeks to create a vibrant U.S. reproductive and maternal health market that produces just outcomes for all — and that means empowering all women and birthing people with affordable access to equitable care.

Research shows that a range of approaches (e.g., doula care, community-based midwives and expansion of Medicaid services) could improve reproductive and maternal health outcomes and health equity while potentially reducing costs to individuals and the health care system. A growing number of diverse innovators are bringing solutions that center on the health care needs and preferences of communities that are most sidelined by the current health care systems.

Ninety percent of RH Capital’s portfolio companies are founded or led by women or people of color, and all are considered leading disruptors and innovators in women’s health.

Unfortunately, reigning “best practices” in finance routinely exclude diverse entrepreneurs and innovators from access to capital, networking opportunities, wealth accumulation and a host of other resources. This is despite evidence that diverse companies outperform their peers.

In turn, investment choices being made — or not made, depending on who’s in the room — may be leaving stacks of money on the table that could be making the world a safer, healthier, more equitable place for women and birthing people.

So, let’s get our house in order and ask a few tough questions.

How are the marginalized communities most harmed by the current reproductive and maternal health market included in the solution-seeking process? Considering that adverse outcomes typically affect Black, Brown and Indigenous patients at disproportionately high rates, why doesn’t the capital chain have more Black, Brown and Indigenous check writers?

Remember that, according to the U.S. Centers for Disease Control and Prevention, the U.S. maternal mortality rate increased nearly 64% between 2019 and 2021. Meanwhile, non-Hispanic Black women who died of maternal causes in 2021 did so at a rate 2.6 times that of white women.

Fifty-eight percent of U.S. women of reproductive age — 40 million women — live in states hostile to abortion care, and 14 U.S. states have outright banned abortion in the 11 months since Dobbs vs. Jackson Women’s Health Organization overturned the landmark 1973 Roe v. Wade decision that legalized abortion nationwide. These restrictions disproportionately harm women with low incomes and women of color.

Meanwhile, support is growing for making equity a cornerstone of health innovation instead of an afterthought. A study funded by the National Institute on Minority Health and Health Disparities revealed that racial and ethnic health disparities cost the U.S. economy $451 billion in 2018, reflecting a staggering

41% increase from the previous estimate of $320 billion in 2014.

Diversifying the asset management and financial services industry to reflect the communities targeted by investments more accurately will be a Herculean task, but failing to do so is not a neutral act. Failing to do so further entrenches the conditions that created the disparities in the first place, especially among innovators who have been historically marginalized.

Whatever your financial status or position, if you care about reproductive and maternal health equity, make a choice to put capital to work for it.