UofL News: How was the idea for the Health Equity Innovation Hub developed?��

Monica Wendel: The Hub is a collaboration between UofL, The Humana Foundation, and Humana Inc. aimed at closing health equity gaps. It became clear that health equity was a shared goal between the organizations. Realizing this shared goal, UofL Executive Vice President of Research & Innovation Kevin Gardner invited me to lead the development of the collaboration. Not long after, Humana’s inaugural Chief Health Equity Officer, Nwando Olayiwola, was named and both Humana and The Humana Foundation deepened their existing commitment to working towards equitable health systems for each person and community.

UofL News: Break down for us, please, the main mission of the Hub.��

Wendel: The mission of the Hub is to advance social and health equity for structurally marginalized communities. In recognizing that health outcomes and inequities are driven by social determinants, which in turn are shaped by structural determinants, the Hub is committed to working across multiple levels of social ecology in ways that provide communities made vulnerable equitable access to the resources they need to be healthy and whole. We are doing this by integrating the research power of the university, the resources of industry, the expertise of the community in these issues, and the ingenuity and creativity of innovators and entrepreneurs — especially those who hold minoritized identities — in solving health equity issues.

UofL News: Why is this work so important at this time?��

Wendel: Everyone wants to be healthy, but the choices people make are the choices people have. And we don’t all have the same choices – our health care, housing, food and other systems offer more choice and accessibility to some people than others. For Black and brown populations, LGBTQ+ populations, foreign-born populations, rural populations and populations living in poverty, the structures and systems enact and reinforce marginalization that produces health inequities.

It’s important here to differentiate between ‘disparities’ and ‘inequities.’ Health disparities refer to differences in risk, incidence, morbidity, disability and mortality in various conditions between different groups. Health inequities more specifically identify differences between groups that are unjust, unnecessary and preventable. The structures and systems we create and maintain produce inequities — we as a society are responsible for that. But that also means it can be changed. If it’s going to change, we have to change it.��Equity will not happen organically.

UofL News: Please describe the research aspect of the Hub.��

Wendel: A key aspect of the Hub is the integration of research, community engagement, innovation, entrepreneurship, strategic relationships and talent development to achieve specific outcomes toward advancing health equity. This integration is both the most innovative and the most challenging facet of the work; because of it, people in Louisville and beyond will thrive.

I have had the privilege of assembling a team of individuals who are rock stars in their respective areas of expertise. But doing things the way they’ve been done is going to continue to get us what we’ve got – which is inequity. So, our team is intentionally doing the hard work of not operating in silos of individual areas of expertise, and bringing all areas of expertise to the strategies and activities in each of our workstreams. In that way, we are advancing health equity at multiple levels of social ecology and interconnecting community sectors that likely would not otherwise be connected. Those cross-sector network relationships will transform systems to advance health equity and will endure long past all of us.��

Thanks to the Humana Foundation’s gift, the Hub is able to support minoritized researchers and novel health equity research. We put out our first call for research proposals in March, and through a rigorous review process, awarded over $1 million to fund 10 health equity research projects.

UofL News:��As a public health researcher, you’ve worked over 20 years addressing aspects of health inequity and factors related to social determinants of health. How does the Hub build upon what you’ve learned through your own research?

Wendel:��My vision and design for the Hub is grounded in several things I’ve learned over the course of my career. First, people have a right to self-determination. For minoritized populations, our systems have historically stripped away this right.��The people most impacted by health inequities of any kind are the most expert in those inequities, and often have valuable insights and innovative ideas for how to solve them. We must listen and engage the communities affected. Solutions brought in from outside those communities rarely have the intended magnitude of effects.

Second, we must work upstream and downstream at the same time and across sectors — advancing health equity requires organization and strategy. Although the United States has made some gains in health equity efforts, there is still much work to be done in addressing inequities and ensuring everyone has access to resources that support good health. Our downstream interventions must address immediate needs and advance health equity at that level.

But we cannot achieve sustainable gains in health equity unless we also work upstream, with communities that have historically experienced these inequities. For example, inequities in maternal health outcomes for people of color may result from lower quality of care, but they may also result from experience of racism within the health care system. Improving quality of care downstream only addresses part of the problem; if people do not seek care because of distrust of the health care system, they will not benefit from improved quality of care. There must be simultaneous work addressing systemic racism in the health care system. Thus, our upstream interventions must transform systems to reduce health inequities, while downstream, we work to ensure equitable access to health resources. Both of these efforts are necessary, and neither on its own is sufficient.

Third, our interventions must be planned for way beyond the term of a grant. Initiatives intended to advance health equity must not bring needed resources to a marginalized community that then disappear at the end of the grant; this results in real harm to real humans. Any kind of equity work requires intellectual and cultural humility and a conscious intent on doing no harm. There is no substitute.

The Hub was launched earlier this year as a collaboration between UofL, The Humana Foundation, and Humana Inc. aimed at closing health equity gaps facing vulnerable populations. The 10 projects awarded in this initial round of funding furthers this goal by tackling inequities in areas such as access to mental and physical health care and healthy food. Projects were eligible for up to $100,000 per year for up to three years.

Monica Wendel, who leads the Hub, said finding solutions for these challenges will create more choices for people in making decisions that affect their health.��

“These factors play a huge role in our health outcomes,” said Wendel,��a professor��in the UofL School of Public Health��and��Information Sciences.��“We all want to be healthy and whole. But��the choices people make are the choices people have. For communities that have been marginalized, their choices are greatly limited by structural and social barriers. Our goal with the Hub and with this research is to dismantle these barriers, create more choices and thus empower people and communities.”

The funded projects include:��

• • The Pharmacy Accessibility Index (PAI) Project (Lihui Bai, J.B. Speed School of Engineering);
  • Healing-Centered Capacity Building: Social Justice Youth Development Certificate (Aishia Brown, School of Public Health and Information Sciences);
  • An Examination of the Feasibility and Acceptability of a Racial Trauma Processing for Family Health Intervention (Emma Sterrett‐Hong, Kent School of Social Work);
  • Exploring Workforce Development, Well‐Being, and Organizational Readiness to Recruit, Retain Black American Adults Living in Low Resource Communities (Meera Alagaraja, College of ����ֱ�� and Human Development);
  • A Community-Engaged Feasibility Study of hrHPV Self‐Sampling for Primary Cervical Cancer Screening in Sexual and Gender Minorities (Mollie Aleshire, School of Nursing);
  • A Community‐based, Knowledge Translation Approach to Address Neighborhood Factors that Impact HIV Care Continuum Participation (Jelani Kerr, School of Public Health and Information Sciences);
  • Assessing risk factors associated with childhood lead poisoning in Jefferson County: Structural racism and a legacy of lead (Brian Guinn, School of Public Health and Information Sciences);
  • “Getting the Listening” in Louisville: Environmental Health Literacy and Justice in and around Rubbertown (Megan Poole, College of Arts and Sciences);
  • Empowered by the Sun: Exploring the Intersections of Housing Justice and Green Technologies in Louisville (David Johnson, School of Public Health and Information Sciences); and
  • Equity‐Centered, Trauma‐informed Teacher Preparation: Development and Study of a Teacher Residency Curriculum (Shelley Thomas, College of ����ֱ�� and Human Development).

Wendel said the Hub will work closely with researchers and their community partners throughout the projects and plans to open a new round of research funding in 2023. Many projects will be conducted in collaboration with Louisville-based Humana Inc., which will share anonymized data for research purposes.��

“We’re proud to back both research and underrepresented minority researchers to help communities achieve greater health equity and improved outcomes,” said Keni Winchester, director, strategy & community engagement at The Humana Foundation.��“Through the collective efforts of researchers, community partners and the University of Louisville’s Health Equity Innovation Hub, people in Louisville and beyond will thrive.”��

The Hub launched with a potential total investment of $25 million from the Humana Foundation, Humana Inc., and UofL, representing one of the largest single donations in the history of the university. Humana also recently announced it would donate a fully furnished eight-story building, located at 515 W. Market St., to house the Hub’s administrative team and programming.��

“This research is an important facet of the great collaboration we have with The Humana Foundation and Humana Inc.,” Wendel said. “These projects are designed to lead to scalable solutions to health equity issues here in Louisville and beyond.”��

The Health Equity Innovation Hub is an integrated, multidisciplinary collaboration among The Humana Foundation, Humana and UofL that is focused on groundbreaking research, talent development, entrepreneurship and innovation, with a deliberate emphasis on health equity, social determinants of health and digital health and analytics. The Hub seeks to develop solutions for health inequities in Louisville and globally.

“Humana is pleased to donate this building in the heart of downtown Louisville to UofL, and we continue to be strong supporters of the work being done to establish the Health Equity Innovation Hub,” said Nwando Olayiwola, chief health equity officer and senior vice president at Humana. “Having the Hub in close proximity to our downtown offices will allow for better collaboration and ultimately will result in greater impact for the important work being done to solve health inequities.”

“As we considered potential new uses for the 515 building, we knew that we wanted to find an occupant that would add to the vibrancy and diversity of downtown while also aligning closely with Humana’s mission to improve the health and wellbeing of our members and communities,” said Douglas Edwards, senior vice president of enterprise associate and business solutions at Humana. “We could not think of a better neighbor for the downtown business district than UofL.”

“We appreciate Humana’s generous donation of this building to UofL, as well as the ongoing support provided by Humana and The Humana Foundation for the Health Equity Innovation Hub,” said Lori Stewart Gonzalez, interim president of UofL. “We are excited to share more details about the building and the Health Equity Innovation Hub in the near future.”

The program, called “Louisville Skills,” will provide up to 25 individuals the opportunity to build the technical, business and life skills necessary to work in a fast-paced, high-tech environment, preparing them to launch promising careers in the tech industry.

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The Humana Foundation has earmarked $325,000 for the project, which will be targeted to residents in Louisville Metro, particularly in West Louisville.

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“By addressing social determinants of health, or the conditions under which people are born, grow, live, work and age that impact overall health and well-being, we can make Louisville a more appealing place for everyone,” said Walter D. Woods, CEO of The Humana Foundation. “It’s exciting to see two local organizations collaborating and partnering to provide education and improve the financial outcomes of historically marginalized adults in Louisville’s West End.”

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Interapt’s training program has been called “a national model of creating next-generation opportunity” and graduates have worked for and with companies such as Humana, Kindred, NetSmart, Elavon, Accenture, GE, Chase, El Toro and Eagle6. Through Interapt’s Registered Apprenticeship model with the U.S. Department of Labor, top graduates have seen their earnings potential increase to $90,000 just three years out of the program.

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This is Interapt’s first partnership with a major university.

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“Our goal is to improve the financial outcomes of the participants, helping both themselves and their families,” said UofL President Neeli Bendapudi. “UofL will perform rigorous outreach to find participants who have been historically underrepresented in science, technology, engineering and math (STEM) fields. This innovative and forward-thinking partnership demonstrates our unwavering commitment to diversity and inclusion in our community.”

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The training will be taught at UofL’s Hite Art Institute in West Louisville and will include foundational software programming concepts and software development skills. To ease the burden for students, they will receive a stipend of $100 per week during the program.

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“Companies across the world are realizing that investing in skills and human capital is a cost-effective way to create new, high-wage jobs in the community while solving a major technology talent shortage. We are excited to start this partnership and create new and innovative pathways with the University of Louisville,” said Ankur Gopal, founder and CEO of Interapt.

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Each year, companies are unable to fill thousands of new openings in the tech industry through traditional hiring practices. Gopal said the UofL and Interapt Louisville Skills initiative will help develop the next generation of workers and provide an innovative alternative to solving this talent shortage.

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