Troy W. Vincent (00:03.051)

Welcome everybody to the Navigate People First podcast. I'm Troy Vincent, CEO of Navigate. And today we're talking about a topic that has been overlooked far too long and is finally getting the attention it deserves. Women's health in the workplace. At Navigate, we believe for years that women's health can't be treated as a side program or a niche benefit. It has to be a core pillar of any serious wellbeing strategy.

What excites me about this conversation today is that St. Luke's hasn't just embraced that idea for their own people. They've taken services into the community to support businesses and organizations across their entire region.

Troy W. Vincent (00:48.725)

I'm joined by two incredible leaders. First, guest, Don Dubois, who is the Director of Community Outreach at St. Luke's, who has spent the last several years building programs that meet women where they are, at work, at home, and in their communities. Alongside Don is my colleague, Dr. Jen Musick, Navigates VP of Clinical Strategy, who leads our clinical strategy and is deeply passionate about closing the gaps in care.

that women experience, especially in areas like cardiovascular health. Today, we're going to explore a key question. What does it look like for employers to move from offering a women's health point solution to building a true enterprise level women's health strategy that drives outcomes for the women and also value for the business? So let's get started. Welcome to the podcast.

Dawn DuBois (01:41.888)

Thank you. Thanks for having us.

Jennifer Musick (01:42.884)

Thank you. Let's go.

Troy W. Vincent (01:59.147)

Dawn, Dr. Jen, thanks for joining. It's wonderful to see you guys.

Jennifer Musick (01:59.078)

Thank you.

Troy W. Vincent (01:59.147)

Really appreciate the effort to be here today. And Dawn, let's get started here. You've had a unique path from starting your career at the police department to leading community outreach at St. Luke's for the past 16 years. Can you maybe share a little bit about your journey and how it shaped your passion towards women's health?

Dawn DuBois (02:19.912)

Sure, as you said, that's a far cry, very juxtaposed, right? Starting at a Metropolitan Police Department, which was predominantly male at that time to coming to a healthcare organization, which is predominantly women still at this time. So very different, but I think you summed it up in your intro that it's important not only to recognize the differences that I think Dr. Jen will speak to also, the differences in women's health and how they present and what their changes look like is a transition from young girls all the way through menopause and beyond. They're very distinct stages of life and need to be recognized, especially considering they're making up, women are making up a huge proportion of our workforce. So time for some real action and not just words on that.

Troy W. Vincent (03:09.654)

So you've been director of community outreach since 2020, correct? Maybe give the odds, we have a lot of healthcare systems that we get to work with at Navigate. Maybe talk about what does your role look like day to day and how did women's health become such a central part of your work?

Dawn DuBois (03:15.029)

Mm-hmm. Mm-hmm.

Dawn DuBois (03:30.055)

Sure. I had really good mentors and I stepped into a really good spot. St. Luke's has been in the women's healthcare business for a very long time. I've been in my role as directors, as you said, since 2020, but I started with this community outreach team at St. Luke's in 2014. So I had a track record building up to it and I really watched the women's services come into their own. We had some really great partners that, helped us through all of that that really was able to shine a light on women's health and the importance of that. And I think we're in a bit of a unique spot because we are a healthcare organization and are continually monitoring the community's needs, their gaps in cares, which include women mostly. And so really a unique spot to see where women need care, where some of the gaps are, where some of the silos are. where the access deserts are. And so we're able to take that information that we're looking at for our patients. But that goes way beyond the walls of the hospital out into the community and you can see where those are.

Troy W. Vincent (04:42.7)

Dr. Jen will bring in on here over the last five years, Navigate has really made an effort toward women's health as a core pillar and focus. You coming over to us and helping us to put that perspective even more so. When you think about women's health and you think about it being its own pillar and wellbeing strategy, where do you go when it comes to that program and how that side of the table could really use data for good in the trending aspects of what employers are using these days.

Jennifer Musick (05:17.412)

Yeah, for sure. Thanks, Troy. Yeah, as you said, I mean, to me, women's health isn't a niche, it really is central to population health. And I would say women's health historically has been treated as moments in time or episodic, right, from fertility to pregnancy to menopause. But it's really a continuous health journey. We don't ever stop being women. And so when we start I believe that when we start to treat it that way, that's really when we're going to start to see meaningful outcomes, especially as it relates to reducing cardiovascular risk in women.

Troy W. Vincent (05:55.348)

So Dawn, when you think about your work, and I know you wear a lot of hats at St. Luke's, and you bring women's health into all aspects of those. Maybe touch on a little bit when it comes to the community outreach and women's health, the executive health, all the things that you're doing there at St. Luke's to kind of connect the dots when it comes to women's health.

Dawn DuBois (06:17.876)

Sure, I was just gonna say and kind of tagging into what Dr. Jen said, I think that that is one of the things that is really coming to light for women's health, that it's not episodic, it's not, okay, let's treat for this, now let's treat for this, now let's treat for this. It's really that full continuum. And that happens at very different ages for everyone. So it's not like you can say, okay, here's what we're doing in this decade. And then again, in this decade, it's really a full continuum of care that is coordinated, that is not separated, that's not siloed. one thing that I think is awesome and amazing that's really driving some change, what I see, not only in the community, not only in our hospital clinics, but as you mentioned, things like executive health or concierge health, that it is basically being demanded now that there is cooperation, that people are able, that women are able to not have to go see an OBGYN for this and see their cardiologist for this and see a primary care for this, but it's a really cohesive coordinated effort throughout life because they all flow and feather into one another. So yeah, I'm really seeing that. And I think it's being driven by the women that are receiving the care. Like, yeah, this isn't good enough. I want better. So.

Troy W. Vincent (07:35.04)

Yeah, I see. Yeah, and that's one of the things I love this model. It's been one of the most, I would say, proud things that we get to work on with St. Luke's. You think about, you know, St. Louis region and you think about we get to work with your employees at St. Luke's, a wonderful program there, but then also with businesses coming to you for initiatives and looking at What are they asking you for? Are they starting with fertility, maternity? What are companies coming to you when it comes to helping their employees with initiatives that might connect them to the community and the health system?

Dawn DuBois (08:20.019)

Sure, yeah, and that's a really great question because some of the employer groups that we work with are sophisticated. I mean, they have really kind of thought this through and it's really part of their culture and ingrained and interwoven. Some of them have female leadership, so they're a little more in tune to some of the phases in a female's life, not only the demands of work, but of home. And some of them are not, some of them are not there at all. So we get a wide variety.

I would say for us, the majority that we get questions on or get asked about referral or navigation pieces, definitely OB-GYN. And when I think OB-GYN, I used to think just babies, right? Not just babies. It's like the pre-pregnancy planning and prep work that comes with that, the actual birth, then the postpartum work that comes to that, having a family. So it's bigger than just.

Troy W. Vincent (08:48.681)

I say.

Dawn DuBois (09:15.716)

an OB-GYN giving birth, it's really that full spectrum. That is probably in the workforce. Number one, and closely followed by, if maybe not overtaking number one, is the mental puzzle woman. And what do all of those symptoms and signs mean? And that is really something that has been understudied, under-resourced, and overlooked. So that's a big, big area that we're seeing lots of demand in.

Troy W. Vincent (09:46.701)

Jen, I love your take on this too, because you're working across all of our clients at Navigate, our current clients, then working on some folks that are coming on board. When we think about our internal efforts at Navigate, maybe share a little bit where you see organizations doing well on women's health or where they're still falling short that we could be helping them in what we're offering out.

Jennifer Musick (10:10.296)

Absolutely. Well, again, just to piggyback off of what Dawn mentioned, Troy is like, that's where I think the market is serving employers well, right? Is we know about fertility, pregnancy planning, pregnancy support and menopause. I think where the market really has some gaps and opportunity and really is fragmented solutions, right? So making sure that we're driving engagement, that's a challenge when these fragmented solutions kind of exist. They're not connected across the life stage. So again, back to like the continuous cycle, rather moving away from this episodic support to more of a continuous support model. And it's not really tied to outcomes at the moment. not in these, these women initiatives and solutions aren't really integrated into an employer's overall wellbeing program. And then to me, the biggest gap is the cardiovascular risk amongst females. Heart disease is the number one cause of death for women. Almost one in two women experience heart disease. About 50 % of those women have hypertension. So again, really having, at least at Navigate, my passion now has been how do we close that gap? If we've addressed. We've addressed fertility, we're addressing pregnancy, we're addressing menopause. How can we better address the cardiovascular risk amongst women? And women need a bit of a different approach. We have an opportunity to really connect hormonal health to metabolic health and the risk for cardiovascular disease. So I think my real point of view there, Troy, is two things that navigate. One is how do we bring cardiovascular health into the dialogue when it comes to women's health? And two, how do we actually bring women's health initiatives into an employer wellbeing program?

Troy W. Vincent (12:08.992)

Dawn, know you want to comment on that. Where are you at on that?

Dawn DuBois (12:10.855)

Well, I could not agree more. mean, it's back to that you can't have the siloed care, right? It's that you have, it has to be that continuum of care. You have to have a provider in place that sees the entirety of that, that they just don't, they're not just looking. I mean, you can't separate that cardiovascular risk with that hormonal balance or imbalance that they might be having. That's hugely important for the base to address those cardiovascular risks, which then of course also flows into all of the other things, right? The nutrition and all, mean, everything that comes through that. So we're back to, it has to be a coordinated effort, a continuum of care and all of those gaps. I think it menopause is when it just really starts to show its ugly head. If you don't have that access or you don't have that provider in place, that's where you really start to see it. 100 % on board with the cardiovascular and the presentations are different for women when they're presenting with heart disease then then what we would typically see in men and sometimes overlooked or underestimated and so Just really making sure that that those differences are known and brought to the surface. Yeah

Troy W. Vincent (13:42.805)

So Dawn, you make a really great point. The community model and my love of history, the spirit of women, the program that you had has a very rich history at St. Luke's. COVID put a little damper on that, what not, like you. I just want everyone to kind of understand the Spirit of Women program that you had, you know, what happened during COVID, you guys sunset it, but you're evolving it now and you're bringing it back. You know, maybe touch on that because it's certainly a wonderful program that connects the community to businesses and organizations and can really be a wonderful women's health program that really connects the dots. So maybe, would you mind touching on that in the Spirit of Women program?

Dawn DuBois (14:28.102)

Sure, yeah, yeah. Yeah, and when I talk about St. Luke's rich history with women's programming, that's the program that I'm speaking of is our Spirit of Women program. And it was in place for, you know, 10, 12 years. And what was particularly nice about that, again, that, you know, we might be in a little bit of a unique position here at St. Luke's being a healthcare system that it's really driven by data. What do women want in our community? What are we seeing? As a non-for-profit organization, we have to do a needs assessment every three years, assess where those gaps are, and then make a plan, make an improvement plan to hit those. so women's health always pops up. Ironically, our respondents to that are historically about 80 % women too, just to throw that in there. So it's a very, very top-heavy voice for women in that. Not that men aren't welcome, but those are the respondents that we're getting.

So it's really data driven that we're seeing. But what was so great, I think, about the Spirit of Women program is, as most of us know now, and it's out there in literature, women are really making a lot of the healthcare decisions. Some of the resources show up to 80 % of those decisions for the immediate family, for extended family, for friends and neighbors, are being made by women. So being connected to women is very important that they are educated, that they are knowledgeable that they know how to access what is available in their community, that they take action. And so when we, our program really surrounded that education piece, being accessible, building a support system within the community, not just with our hospital system, but with other partners in the community and with themselves. And honestly, that was the biggest. I think that made our women's program so successful is that the support it got from the community. We were just a player in that at that point. It was really the community that took hold of that and and it did or did you know events and fundraisers and had support groups that they did and walking clubs and we at that point we were just kind of a bystander just helping facilitate it really took off. As you said, COVID knocked us a bit because

Then suddenly after that, the events that were needed or wanted changed a little bit. And ironically, I I think somewhat for the good, because as now we have merged post, what we're seeing is that the younger age group, those that are in the fertility stages, the pre-planning pregnancy, maybe the early menopause, maybe the early chronic risk conditions, they are really looking for different types of access and education digitally is a great example because of where they are in their life and what their days look like. It might be family, full-time work, and we're still seeing those maybe a little bit older in the population that still want some of those on-site. No, I want to have a walking club. No, I want to go and have a coffee and conversations, which is one of the programs we have. We want to have those things.

Troy W. Vincent (17:42.988)

We are competitive. So thank you for your question.

Dawn DuBois (17:45.791)

It really emerged almost as two separate programs, but really being built into one, which is great.

Troy W. Vincent (17:52.181)

Yeah, and you think about the education side of things too, and I'll tell you, we think about cancer being one of the major focus around employer health, community health as a whole right now. You think about young folks that you're seeing cancer come downstream into our younger population. And you started to see where looking a preventive fertility when it comes to cancer care and really focusing on that. Certain things that people don't even really think about, but now being connected to the hospital, knowing the services, being familiar with them, those women programs go a lot further and are really unique to some folks during important times. Dr. Jen, I kind of want to get your take on the industry side of things. We've been talking about women's health for a long time, women's health coaching, looking at that. Maybe touch on the women's health coaching that we're doing, who it's serving, and maybe how does that sit inside the broader scope of how we're helping people on their wellbeing programming with our women's health coaching.

Jennifer Musick (19:03.462)

Absolutely. I'm happy to talk about that. I'm proud to say, right, that we're trying to support women's health coaching in an area that there's gaps, right, that there's an opportunity to better support and better help. And so Navigate, our Navigate Women's Health Coaching program is really going to support women of all ages. Again, back to what's available today is often very episodic. So let's not create another episodic support system. Women have enough of those really effective tools and resources available. So Women's Health Coaching at Navigate is going to support all women across their entire life cycle. Why is that important? We said it's never too early to start. If I'm a 23 or 24 year old employee and my dad died of early heart disease, I may want to engage in women's health coaching to better understand what I can do today at 24 to make sure that I don't end up in that same situation. We often talk about, know, we go away to college and we gain freshman 15 and our 20s that might turn into additional weight gain and understanding, right, the behaviors that become long standing in our 20s and really increasing our risk for metabolic health issues and cardiovascular disease. So we want to support those women as well.

Along with women that might have gestational diabetes, right? So if we take that as an example, women with gestational diabetes are at significantly higher long-term risk of type 2 diabetes and cardiovascular disease, but most solutions won't follow her kind of beyond pregnancy. So we can actually prevent the progression. Our program will be for her or a female who was already experiencing risk factors for cardiovascular disease, or they have concerns or questions and really want to get ahead of things. It really is about preventing chronic disease specific to women, right? And really, again, back to that hormonal impact, really helping women understand how hormones play a role in metabolic health from obesity and achieving healthy weight, all the way to pre-diabetes and developing glucose imbalances. So really all about supporting women across the spectrum with or without risk factors, all in an effort to really help raise awareness, much like Dawn was saying, Educate, raise awareness, and really help to prevent the to cardiovascular disease.

Troy W. Vincent (21:33.325)

So I'm going to ask both of you this question. When you think about what does success look like when women's health is fully integrated into an organization, a company's well-being strategy? Maybe what would the employee feel? What would the executives like to see in the data? What does that look like? What does success mean? Don, I'm going throw that your way first.

Dawn DuBois (22:02.508)

Sure. And that is a great question, right? Because I think, you know, from the end user, if I'm the woman at the employee, at the employer group, to me, feels it would be someone I met a place that I know that people understand what I need, that they understand. And this is a difficult one to say because I want, I would think you would feel understood that there wouldn't be anything that would be off limits to come and talk about. Like, right? I mean, some of those things that we're talking about when your hormones are imbalanced, that's kind of ugly. That doesn't always present well. Or when you are fearful that you are, you know, going to have a heart attack or that you have high blood pressure, but you don't know how to take care of it. Those things present in not a great way in the employer session and section. So, as an employee, I would want to know that I can come and talk about those things, that they are normal, that I can get care for those, that it's not off limits to discuss, and that I have some leeway and some flexibility to take care of myself so I can be a great employee at work. From the executive side standpoint, I think it's all the things that we see in great employee health programs anyway. know, showing up to work happy, being productive, being engaged making it a great place to work, loving to be there every day. That's what the executive thing sees. But the employee needs to feel that freedom and flexibility to be able to say, here's who I am today.

Troy W. Vincent (23:43.894)

Fantastic. Jen, you want to add to that?

Jennifer Musick (23:45.931)

That's a great response, Dawn, for sure. I think what that looks like is that we really are helping identify risk, personalizing the experience for these women in the workplace and guiding them to the next best action, which really is a personalized level of support at the right time. And what that really feels like for the female is, you know, I have improved symptoms that I'm reporting.

I'm completing preventative care. I understand what my risk factors are. I'm addressing those areas of risk if I have any, or if I don't have areas of risk, I'm working with my health coach to prevent risk from occurring. And I feel heard, like Dawn said, I feel supported. For an employer, what that looks like is a higher rate of preventative care completion for women. In addition to all the things that Dawn said, which are so massively important, is an engaged employee. When we look at the objective data, right, we've got good preventative care compliance, we've got biometric improvement and we've got risk reduction that again reduces the risk of complications, cardiovascular disease and even cancers, Troy, to your point.

Troy W. Vincent (00:01.946)

One of the things that we found out with our podcast is that we've got a lot of businesses that are just getting started in health and wellbeing and thus means they're probably just getting started in women's health. So Dawn, maybe touch on what are two or three building blocks that an HR person who's getting started in a wellbeing program in women's health, maybe one or two building blocks that across data or leadership sponsorship that might be in their programming that they wanna really think about to get things off to a good start.

Dawn DuBois (00:32.407)

Sure. And we have several clients that are in that position now. And the first thing we always talk about is through your HR team, really take a full inventory of what you do have available and what benefits are out there. Most of the times it's more robust than you think, and there's more options and more resources available. So take your inventory, see what you have, and then create a really good communication plan for those employees that it will affect, those women that those benefits will affect. Make sure that you have a good communication plan in place so that they know how to access those and how to use those and monitor. Are they being used? You don't need to know who, but just are they being used and they're out there. And if they're not, maybe that's time to readjust and take a look, which leads me to my second point is ask. Ask your employees, what do you all want? What do we need? Where are we short on some of these? Because if you have benefits are underutilized, maybe you shift them over. they didn't know they had those benefits. So just ask and assess.

Troy W. Vincent (01:38.722)

Which leads on the executive side of stewarding our budgets well, right? It's being able to do that resource audit, see what's being used, what's not, looking at that, being able to say, Doc, we need this when it comes to our programming. When you think about programming or measurement or the data, where does your head go on those building blocks, one or two that might be a good foundational start?

Dawn DuBois (01:43.039)

Yeah.

Jennifer Musick (01:58.753)

Mm. I would definitely say, much like Dawn said, assess your resources and then also understand what you're trying to accomplish. So what does success in women's health, supporting your female employees, what does that look like in the long run? A year from now, three years from now, what has happened so that you can back into how to use the resources you do have available? I think really understanding where you're going. Part of that too is understanding from your female workforce, like what does that look like for them, but really making sure you understand what you're trying to accomplish so that you can properly assess your resources and then align them towards that objective. But if you have to start somewhere, always start with preventative care and then start with risk identification. Those are pretty much the foundational blocks regardless of gender. Then support your women with proper know, women focused resources and solutions.

Troy W. Vincent (25:02.444)

It's an important conversation and I think the more that we have this, the more that folks listen to this, the more that we see where we can do more than just one-off campaigns. And we think about one-off campaigns. You certainly can learn from those. But if we think about that whole strategy, I think that's where the value of having a great partner when it comes to St. Luke's, being in the community, being able to drive that. I think about I work with the zoo and the county and all the different things that are smaller businesses that don't have the budgets to do a lot, but they definitely want to have a great culture. They want to care for their employees and they want to give them clinical options when it comes to their care. So being able to reach out into your health system and be able to work with your health system when you got 100 employees, 500 employees, and really just connect that continuum is something I think of a wonderful effort. And I think about all the wonderful health systems in the country that if they could model what St. Louis is doing in St. Louis, we'd have a population, we'd have healthier communities, and we definitely would be supporting our women in a way that models the spirit of women across what you guys are doing for a lot of time, lot of years. So really appreciate Guys, you know, we've talked about what we're doing today, what we did in the past, what we're doing today that leads up to my favorite part of the podcast is our best day ever. It's something good.

Troy W. Vincent (26:33.034)

Daw, this your first podcast, so the best day ever. I'll let Dr. Jen go first, but best day ever, something good that's going on in your life, your family, your community. We just want to share that and end the podcast with a good. So, Doc, what do you got?

Jennifer Musick (26:46.95)

My goodness, my good is that we are gearing up for a celebratory May. My oldest daughter is graduating from the University of Iowa, Go Hawks, and she's getting married. So she's trying to make her dad and I, yeah, completely crazy, but we are here for it and we are looking forward to it and we are in the thick of it. And yeah, gearing up for a really fun May.

Troy W. Vincent (27:11.648)

How you doing, Mom? You doing all right? You hanging in there?

Jennifer Musick (27:14.468)

Yeah, women's health coaching. could use a little stress before at the moment. Okay. Thanks, Dawn. yeah. And then I'm going to see Dawn in June. So I'm super excited about that.

Dawn DuBois (27:15.648)

Yeah. Let's connect.

Troy W. Vincent (27:28.684)

Dawn, what are you thinking? What's the vest day ever?

Dawn DuBois (27:32.603)

I was just gonna say for me today, and this happened just this morning, I was rushing around, I had an early meeting, 7.30, it was raining, I couldn't find a parking spot, you know the scenario I'm talking about. Then I was running over to my office to make sure I could make it for another meeting, and I'm a little bit grumbly, and I see, I get the privilege of working with our adults with down syndrome center. I see one of our adults with down syndrome clients. That smile, you know, they give the best hugs in the world. And they're like, Dawn, I'm like, what could be a better day than to slow me down and see this face and just the world is good.

Troy W. Vincent (28:13.386)

Yeah, I'll tell you what, I love that. You know, that's one of my, I know that parking lot, Dawn, and it's been fun running through the rain from the back. yeah, the Albert Pujols facility that you have there for adult down syndrome is one of the best in the country. And I had the privilege of being able to walk through there with you one time. just, the passion to care and the individuals that are there and what you're doing for the community is just, is one reason that this diehard cub roots for that seems to us cardinal that's going on down there.

Dawn DuBois (28:46.024)

Yeah.

Troy W. Vincent (28:49.484)

It's wonderful place. Well, hey, I got to say my best day ever is that my mom's going to listen to this podcast. And so, you know, she's the one that likes this a lot. We get those great numbers from probably, you know, my mom and other folks as parents here at Navigate. But I'll say this, my mom, this is coming from the fourth son of a mom who served in healthcare administration for over 40 years. And I saw my mom work with docs and recruit docs and nurses and connect to the community and really focus on women's health and really doing that at a small rural hospital and all the effort that she did. I learned through her example in saying that, know, honey, 80 % of the folks working at a hospital are ladies. Almost 90 % in our family, 100 % of decisions in healthcare are made by with this one lady. So we need to make sure that the ladies know that they are cared for, that we have opportunities for them. And my mom created this culture at her health system where her little red hat club, everybody that she worked with, still get together every month in our hometown of Nevada, Iowa. seeing what my mom did in connecting the community and seeing now what she did at a small level, what St. Luke's is doing at an even larger scale.

Jennifer Musick (29:45.766)

Mm-hmm.

Jennifer Musick (29:58.373)

and you can see it.

Troy W. Vincent (30:14.742)

and the results that happens from that is it's one of the most inspiring things that I get to do and get to be a part of. So mom, I love you. Thanks for being a great role model and leading the way. anyway, hey, Don, it's awesome to see you as always. I appreciate you more than you know. Doc, you're the best and good luck with everything coming up in the next couple of weeks. I'll see you before that, but I truly appreciate all the effort and...

Jennifer Musick (30:34.97)

Thank you.

Jennifer Musick (30:40.599)

I know.

Troy W. Vincent (30:45.194)

Breaking beyond the traditional focus of women's health and really putting that out of just a niche into a full strategy and talking about this topic. So thank you all for what you do every single day. Thank you for caring for others and I appreciate everyone listening. Please, if you like what we're doing, let us know. If you've got topics that we should be talking about, let us know. We do listen and navigate and we're here to do good things for you. So appreciate you all and have a great, great rest of April and we'll see you soon.