Assessing entrepreneurship in governmental public health

Public health and social entrepreneurs as activators of equitable health ecosystems

OBJECTIVES

To describe approaches that public health and social entrepreneurs take to address health equity, and identify strategies for equitable collaborations with these entrepreneurs.

METHODS

We leveraged data from semi-structured interviews, conducted August to October 2022, with 20 public health and social entrepreneurs who focus on drivers of health and health equity. Two researchers employed content analysis, guided by a prior framework.

RESULTS

To support health equity, public health and social entrepreneurs: center equity, critique biases, innovate for inclusion, engage translational expertise, catalyze capacity, and activate equitable systems. Equitable collaborations are supported by re-examining roles, de-conflicting organizational barriers, prioritizing representation, mitigating bias in generating evidence, and employing equitable capital.

CONCLUSIONS

Public health and social entrepreneurs can uplift equity across health service design and delivery. More equitable collaborations can advance this work.

Curricula and resources related to social entrepreneurship and public health innovation within schools of public health in the United States

This paper examines the current state of social innovation and entrepreneurship programming, courses, and centers within schools of public health through a survey data analysis. This report presents a cross-sectional survey conducted among faculty members of public health schools in the United States. The survey aims to determine the availability and current state of student-centered programs and courses centered around social innovation and entrepreneurship within schools of public health. Insights were drawn from 19 professionals across 15 schools of public health. Uncertainties surround the sustainability of current programs, with insufficient funding, human resources, and the need to teach more pressing topics identified as the most significant obstacles. Key areas identified as opportunities for growth were faculty engagement, expertise, and funding to expand more structured programming.

Does public health policy quality foster state innovation capacity? Evidence from a global panel data

The design and implementation of public health policy may shape state innovation capacity with governance effectiveness, political stability, and government integrity. Previous studies, however, failed to incorporate these relationships simultaneously. This study aims to combine two distinct scholarships to examine whether the quality of policies in the public health sector contributes to state innovation capacity. We extracted data from the WHO international health regulatory dataset covering the WHO Member States between 2010 and 2017 to investigate the relationship (N = 145). Our fixed-effects models and regression discontinuity design (RDD) suggest a positive impact of public health policy quality on state innovation capacity. There are several contributions to the study of the relationship between public health and innovation in this study. Firstly, it fills a theoretical void concerning the relationship between policy development and implementation in the public health sector and country-specific innovations. Second, it provides an empirical quantitative analysis of policy quality in the public health sector. Third, this study contributes evidence that public health plays an important role in fostering state innovation beyond urbanization, investment in science and technology, and foreign trade. Furthermore, our quasi-experimental evidence found that this mechanism may be significant only between the more politically stable countries and the most politically stable countries. These contributions have empirical implications for governments across the world that seek to balance public health and innovation capacity in the context of the post-pandemic era.

Impact of Entrepreneurship on the Quality of Public Health Sector Institutions and Policies

The purpose of this paper is to investigate whether public health entrepreneurship principles implementation in the public health sector are alternative ways of promoting an immediate improvement of healthcare infrastructure. To contribute to the literature on the impact of public health entrepreneurship on public healthcare infrastructure, we estimate two empirical models, with the first model having institutions and the second model having public healthcare policies as the dependent variable. Our empirical analysis is based on the WHO international health regulation data for all WHO member countries (in order to achieve a balanced panel, we decided to retain 192 of them), covering the period from 2010 through to 2019. The main results obtained using a Poisson panel regression indicate a positive relationship between employing more entrepreneurship within public healthcare and the quality of public healthcare infrastructure represented through institutions and policies. This study produces several contributions to the stream of research on public health entrepreneurship. First, it makes a theoretical contribution in the way that it fills the lacking literature on the relationship between entrepreneurship within the public health sector and efficiency of country-specific public healthcare infrastructure. Second, it offers an empirical quantitative analysis of entrepreneurship that is generally lacking. Concerning policy implications, the third contribution of this paper is the provision of evidence showing alternative ways to improve healthcare infrastructure other than traditionally observed investments in physical infrastructure.

A Structured Pathway Toward Disruption: A Novel HealthTec Innovation Design Curriculum With Entrepreneurship in Mind

The typical curriculum of training and educating future clinicians, biomedical engineers, health IT, and artificial intelligence experts lacks needed twenty first-century skills like problem-solving, stakeholder empathy, curiosity stimulation, entrepreneurship, and health economics, which are essential generators and are pre-requirements for creating intentional disruptive innovations. Moreover, the translation from research to a valuable and affordable product/process innovation is not formalized by the current teachings that focus on short-term rather than long-term developments, leading to inaccurate and incremental forecasting on the future of healthcare and longevity. The Stanford Biodesign approach of unmet clinical need detection would be an excellent starting methodology for health-related innovation work, although unfortunately not widely taught yet. We have developed a novel lecture titled HealthTec Innovation Design (HTID) offered in an interdisciplinary setup to medical students and biomedical engineers. It teaches a future-oriented view and the application and effects of exponential trends. We implemented a novel approach using the Purpose Launchpad meta-methodology combined with other innovation generation tools to define, experiment, and validate existing project ideas. As part of the process of defining the novel curriculum, we used experimentation methods, like a global science fiction event to create a comic book with Future Health stories and an Innovation Think Tank Certification Program of a large medical technology company that is focused on identifying future health opportunities. We conducted before and after surveys and concluded that the proposed initiatives were impactful in developing an innovative design thinking approach. Participants' awareness and enthusiasm were raised, including their willingness to implement taught skills, values, and methods in their working projects. We conclude that a new curriculum based on HTID is essential and needed to move the needle of healthcare activities from treating sickness to maintaining health.

Toward an Understanding of Public Health Entrepreneurship and Intrapreneurship

This paper describes a framework used to understand public health entrepreneurship and intrapreneurship for the purpose of pedagogy and practice. To ground this framework in the academic literature, a scoping review of the literature was conducted with application of a snowball method to identify further articles from the bibliographies of the search results. Recurring themes were identified to characterize common patterns of public health entrepreneurship and intrapreneurship. These themes were design thinking, resource mobilization, financial viability, cross-disciplinary collaboration, and systems strengthening. Case examples are provided to illustrate key themes in both intrapreneurship and entrepreneurship. This framework is a starting point to further the discourse, teaching, and practice of entrepreneurship and intrapreneurship in public health. More research is needed to understand implications for power and privilege, capacity building, financing, scaling, and policy making related to entrepreneurship and intrapreneurship in public health.

Public Health Entrepreneurship: A Novel Path for Training Future Public Health Professionals

Background: As schools of public health adapt to the new Council on Public Health (CEPH) competencies there is increased relevance in training public health professionals in public health entrepreneurship. Public health entrepreneurship provides an alternate process to traditional academic approaches focusing on translating public health knowledge into effective, sustainable, and scalable solutions. Objective: This study reports student perceptions of public health entrepreneurship and training needs for successfully equipping future public health professionals. Methods: Focus groups were conducted in April 2018 with graduate public health students in pilot entrepreneurship courses at two U.S.-based CEPH-accredited schools of public health. Results: Participating students (n = 29) were mainly pursing MPH degrees (62%) within Health Management and Policy (38%) or Health Promotion/Global Health (31%) departments. Most students (52%) were between 21 and 30 years old. For 71% of students this was their first academic course with a focus on entrepreneurial thinking. Four themes emerged regarding public health entrepreneurship and training needs for becoming a successful public health professional of the future. Students confirmed a place for public health entrepreneurship in the emerging educational paradigm because it is action-oriented, skills-driven, and fosters innovation through inter-professional collaboration and cross-pollination of knowledge and skills between professional disciplines. Conclusions: The competencies required for public health entrepreneurship are in alignment with CEPH competencies and are well-received by the next generation of public health professionals as an adjunct but nascent approach to stimulate public health innovation.

Public Health, Embodied History, and Social Justice: Looking Forward

This essay was delivered as a commencement address at the University of California-Berkeley School of Public Health on May 17, 2015. Reflecting on events spanning from 1990 to 1999 to 2015, when I gave my first, second, and third commencement talks at the school, I discuss four notable features of our present era and offer five insights for ensuring that health equity be the guiding star to orient us all. The four notable features are: (1) growing recognition of the planetary emergency of global climate change; (2) almost daily headlines about armed conflicts and atrocities; (3) growing public awareness of and debate about epic levels of income and wealth inequalities; and (4) growing activism about police killings and, more broadly, "Black Lives Matter." The five insights are: (1) public health is a public good, not a commodity; (2) the "tragedy of the commons" is a canard; the lack of a common good is what ails us; (3) good science is not enough, and bad science is harmful; (4) good evidence--however vital--is not enough to change the world; and (5) history is vital, because we live our history, embodied. Our goal: a just and sustainable world in which we and every being on this planet may truly thrive.