A Year to Rebuild & Reconnect

Thoughts on 2021 from Able Partners

We have been active investors in health and wellness for nearly a decade, a category that exists because of the underlying inadequacies in our current healthcare system. Never have those inadequacies been more pronounced than during the Covid-19 pandemic. The impact of chronic conditions and gaps in our systems of care have proven to be devastating.

However, if there is a silver lining to the pandemic, it has been the increased attention, from entrepreneurs, investors, companies and government, on our physical and mental health and wellbeing. As we start 2021, we are optimistic about the roll out of an effective vaccine and believe that innovation in the private sector, accompanied by support from the public sector, can help us meaningfully improve upon the state of health and the quality of care going forward. More than ever, our mandate to help the consumer live a healthier, happier and more meaningful life, with a particular interest in categories that have historically been stigmatized and overlooked, is critical to our collective efforts to rebuild and reconnect.

Here are some of the innovations we are most excited about in 2021 that will help to close The Wellness Gap:

1. Data-Driven Mental Healthcare: When we think about the data, insights, research and available treatments in mental health, it is clear that unlike other clinically diagnosed conditions, the infrastructure and related insights remain nascent. The average delay between onset of mental illness symptoms and treatment is 11 years¹, and only 66% of adults with a serious mental illness received treatment in 2019.² There are specific areas within digital mental health care that we believe will help to accelerate access and efficacy: (1) measurement and monitoring infrastructure and (2) data-driven technology to personalize care for specific demographics.

We believe that measurement and monitoring infrastructure will have a significant impact on care delivery, allowing providers to diagnose, predict and proactively intervene. In turn, this will reduce cost in the overall system while helping to improve outcomes for the patient. A pioneer in this field, Ellipsis Health, has developed voice technology that can analyze acoustics and words in natural speech to uncover depression and anxiety symptoms over time. Companies like Mindstrong and HealthRhythms collect passive smartphone sensor data — keystrokes in the former and accelerometer data in the latter — that can help clinicians predict and personalize intervention. Springtide, a technology-enabled autism clinic, captures objective longitudinal data at scale in order to monitor progress, removing subjective self-reported input.

In addition, we believe that technology will continue to personalize mental health care to meet individuals where they are at. The diversity of resources available including digital programs, coaching, therapy, group and peer-support, and medication will require sophisticated personalization and care coordination to match individuals with the best care. From subclinical to clinical, Spring Health has developed data-driven technology to help employees identify and access the most effective care plan. Little Otter, focused on mental health in children and early adolescents, has developed proprietary digital assessments — backed by scientific research led by co-founder, Dr. Helen Egger, on anxiety and mood disorders in children — to connect families to a virtual care team that can personalize treatment for specific developmental behaviors.

2. Democratization of Healthcare Insights: Consumers are showing increasing agency and engagement in understanding their own health. Health monitoring technology provides access to data and insights so that consumers can track their own health conditions and use data to make decisions. 42% of US consumers reported using tools to measure fitness and track health-improvement goals in 2020 and 77% say that it changed their behavior at least moderately.³ Wearables, such as Oura, leverage advanced sensor technology to deliver precise insights. These insights proved particularly valuable during the pandemic as Oura has demonstrated the ability to detect early indications of Covid-19 two to three days before symptoms appear.⁴

In addition to data from wearables, we have seen early pioneers increase access to insights from lab testing by bringing testing into the home. Taking that one step further, we are seeing computer vision innovation come to market that will allow consumers to not only test at home, but also access immediate results using their smartphone cameras. Companies like Vessel Health, an at-home wellness platform, allows consumers to use an assay-based test card to measure several different health metrics across nutrient levels, hydration, and stress with immediate results. Access to affordable tests with personalized insights are married with clinical recommendations that are tech-enabled at scale to educate consumers. As a result, consumers can take more control over their health outcomes and proactively engage in targeted prevention.

We believe existing technology will continue to improve so that we can capture additional key health markers from cholesterol and glucose to hormones and disease markers. Eventually, we believe that same technology will be further embedded in our day-to-day so that passive data collection will yield objective and continuous insights at scale. The ultimate impact of this proactive approach will be lower costs and better outcomes compared to our current reactive and resource-intensive healthcare data collection.

3. Infrastructure for the Care Economy: Unpaid care, which has largely been shouldered by women and immigrants in the U.S., has historically helped subsidize the healthcare system. The cost of unpaid care is not included in the calculation of GDP and therefore has gone unmeasured, making it more challenging to advocate for favorable policy. However, Covid-19 has painfully revealed the critical role of unpaid care and the positive externality of caregivers’ contributions.

Unfortunately, as a result of the pandemic and the increased demands on caregivers, women have dropped out of the workforce in unprecedented numbers. Caregiving demands on mothers alone amount to $64.5 billion in lost wages and economic activity.⁵ In the midst of a childcare crisis, we are excited to support companies like Vivvi, who is reinventing childcare with unrivaled flexibility for families. Vivvi’s B2B2C model highlights that other constituents in the ecosystem, namely employers, have played and will play a significant role in furthering the development of care infrastructure.

We have learned — the hard way — that we need to invest in the care economy to increase jobs, reduce gender and income inequalities and keep more women in the workplace. In turn, that flywheel leads to economic growth. We need the private sector to birth new companies that will support the care infrastructure and challenge incumbents to evolve, and we need to call on the public sector to collaborate to support this critical part of our economy.

4. Pathways to (Re)Connect: Prior to Covid-19, loneliness in America was already on the rise as 61% of adults reported being lonely, a 7% increase over the prior year. The statistics around Gen-Z, known as “the loneliest generation,” are even more alarming as 79% reported being lonely in 2019.⁶ Despite technology’s ability to connect us globally, many use social media as a substitute for real connection which has been linked to increasing feelings of loneliness.⁷

Covid-19 restrictions have only further amplified this epidemic, isolating people of all ages from children and adolescents who have missed out on social development to older adults in nursing facilities who have been cut-off from visitors and day-to-day interaction. Social connection, a core psychological need, is critical to our health and wellbeing.

As we re-emerge from this socially distanced state, we will have to address loneliness head-on. We are energized by the growth we have seen in group therapy, such as Real and Pace, and group coaching platforms such as Medley and Topknot, both creating ways for us to connect in our new normal. We are excited to support Chief and Kindred, professional networks focused on shared interests, lived experiences and continued learning. We believe these models are part of the solution, but not the entirety, and we are excited to meet with entrepreneurs who are building concepts to create authentic connection.

For Gen-Z, the most racially and ethnically diverse generation, connectedness will also require alignment with their value set built around inclusion, freedom of self-expression and fluidity. This generation is focused on identity and they see their consumption as an expression of that. As a result, we believe Gen-Z will continue to be drawn to brands like Blueland and Starface that are socially-conscious and mission-driven. We are excited to support companies that embrace the values of this generation and in doing so, build more connected communities.

We believe innovation across these themes will create tremendous economic value and help our society close The Wellness Gap, while addressing the inequities in our care systems. We are excited to meet with any company that is addressing needs that are not seen or heard by our current healthcare system, or met by the products and services from legacy consumer companies.

1. “Mental Health By the Numbers.” NAMI, www.nami.org/mhstats.
2. “Mental Illness.” National Institute of Mental Health, U.S. Department of Health and Human Services, www.nimh.nih.gov/health/statistics/mental-illness.shtml.
3. “Are Consumers Already Living the Future of Health?” Deloitte Insights, www2.deloitte.com/us/en/insights/industry/health-care/consumer-health-trends.html.
4. “Oura Ring Detects the Onset of Fever, a Common COVID-19 Symptom.” MobiHealthNews, 14 Dec. 2020, www.mobihealthnews.com/news/oura-ring-detects-onset-fever-common-covid-19-symptom.
5. Landivar, Liana Christin, et al. “Early Signs Indicate That COVID-19 Is Exacerbating Gender Inequality in the Labor Force.” Socius: Sociological Research for a Dynamic World, vol. 6, 2020, p. 237802312094799., doi:10.1177/2378023120947997.
6. “Cigna Takes Action To Combat The Rise Of Loneliness And Improve Mental Wellness In America.” Cigna Newsroom | Cigna Takes Action To Combat The Rise Of Loneliness And Improve Mental Wellness In America, www.cigna.com/about-us/newsroom/news-and-views/press-releases/2020/cigna-takes-action-to-combat-the-rise-of-loneliness-and-improve-mental-wellness-in-america.
7. Nowland, Rebecca, et al. “Loneliness and Social Internet Use: Pathways to Reconnection in a Digital World?” Perspectives on Psychological Science, vol. 13, no. 1, 2017, pp. 70–87., doi:10.1177/1745691617713052.