Social determinants of health (SDOH) have gained significant attention in recent years. A growing body of research shows that a person's health is influenced by a large number of non-genetic factors, most of which operate outside the realm of health care and are directly attributable to socio-economic conditions. In the U.S., clinical and economic motivations have spurred health care providers, health insurance companies, local governments, and community-based organizations to take action to address SDOH. The fragmented structure of the healthcare industry has, on the one hand, stimulated innovation and experimentation. On the other hand, the lack of standardized measures to capture the effectiveness and efficiency of these interventions and the lack of loci to share information about best practices impede the identification and duplication of successful solutions. In this technical note, we describe the main players and their roles in the SDOH ecosystem, as well as the obstacles that hinder the development of successful, large-scale solutions. The note shines a light on the limitations of the current approach and highlights the potential of the U.S. SDOH ecosystem to succeed in addressing these important determinants of population health.

In 2022, Sophie Desormière arrived at French roboshuttle producer Navya, tasked with charting a new course in a challenging sector. The company, which had recently listed on the Paris Stock Exchange, was burning through cash reserves and needed to transform the promise of its technology into a credible business with a solid revenue stream. In the short term, Desormière had to decide whether, and if so under what pricing terms, to accept an opportunity that recently emerged in the U.S. However, the opportunity involved renting, rather than selling, and also required Navya to operate the service. In the medium term, the company had to navigate questions on whether to concentrate on the software technology that enabled driverless mobility or continue to juggle the hardware side of the business at the same time. Furthermore, questions remained around which market was best suited for Navya's product, and which would be ready with the right regulatory environment to turn promising use-cases into mass transit solutions when the technology allowed getting rid of the on board attendant; at that point Navya might consider re-pricing is AV technology. The form factors Navya should focus on was also hotly debated. Some questioned whether the required regulation and consumer buy-in would come too late for Navya, and whether they should therefore switch the business model to transport goods rather than people. Desormière would need to address all these issues, if the business was to arrive at its intended destination.

Green Monday Group (GMG) was founded in 2012 with a mission to "construct a multi-faceted global ecosystem of future food that combats climate change, food insecurity, public health crisis, planetary devastation, and animal suffering." In 2020, GMG partnered with McDonald's in Hong Kong and launched six dishes featuring OmniPork Luncheon Meat, a plant-based meat substitute that GMG had developed. In February 2021, the chief executive officer and co-founder of GMG had to figure out how GMG could expand its partnership with McDonald's in Hong Kong to the rest of China. McDonald's size and potential in the rest of China far exceeded that of McDonald's Hong Kong, and while GMG had the resources and the determination to expand, it had to decide which marketing strategy to use.

In October 2021, Todd Tucker, senior vice-president of Market Development and general counsel for Arrive Mobility Inc. (Arrive), a Chicago-based provider of last-mile mobility solutions, met with Beth Diaz, innovation director for Sapphire Parking (Sapphire). Sapphire, a parking company based in Seattle, Washington, was struggling to remain in business due to the changing needs of modern society and a shift to a work-from-home culture. While Tucker believed he could generate better business opportunities for garage owners like Sapphire through technology, after his meeting with Diaz, he realized that gaining buy-in from Sapphire's operational leaders would be an uphill battle. Technology could be confusing, and technological inertia existed. Tucker's challenge was to convince Diaz's field team to try new methods for monetizing Sapphire's parking spaces while bringing the business into a more modern mindset.

In May 2021, Alibaba Group Holding Limited (Alibaba), China's biggest e-commerce company, faced a number of challenges. Alibaba, which operated under a platform business model, was confronted with weakened consumer spending due to the coronavirus pandemic as well as increased competition from JD.com Inc. (JD.com) and other e-commerce entrants. To boost business growth and strengthen Alibaba's leading position in China's e-commerce market, Daniel Zhang, the company's chief executive officer, would need to evaluate the possibility of adding a direct online retail model to complement the operations of its flagship platforms Taobao and Tmall. What challenges could Alibaba potentially face in its e-commerce business expansion?

The transition to a green economy is expected to create plenty of new employment opportunities. Unfortunately, filling them will be far more challenging than most employers think. Accenture’s research on the future of the green economy in the Asia Pacific region shows strong employment growth potential. But the research also identified a significant disconnect between youthful demand for “green” employment and where most green job growth is taking place. The sectors not known for sustainability are driving most green job creation. Training and salary expectations also don’t match the emerging opportunities, since the majority of green jobs will not require advanced qualifications, nor command relatively higher salaries. To understand the green jobs landscape in the region the authors targeted, they identified four pathways to reducing greenhouse gas emissions: transitioning transport, supplying low-carbon electricity, decarbonizing the built environment, and greening agriculture and land use. The results showed that transitioning transport had the greatest jobs potential. By breaking down the jobs created across the four pathways into specific industries, the authors found that up to 76 per cent of the 32.6 million new jobs would be in construction (18.1 million) and manufacturing (6.7 million). Tech-intensive roles requiring a highly trained workforce will undoubtedly be part of the equation. However, relatively better paying jobs will be the minority, accounting for less than 8 per cent of the total jobs potential in the Asia Pacific region.

Heineken, one the world's largest breweries, had led a long and successful effort to improve the efficiency of its brewery network. For the company COO, this was a source of pride, and also a challenge and an opportunity. Long curious about the potential for digitalizing the supply chain, perhaps this was the natural entry point for the company's supply chain to create a digital transformation program. Heineken could continue its productivity efforts by leveraging digital technologies. Starting by bringing in digital natives from the outside and identifying key internal stakeholders ready to innovate, Heineken began a process of initial pilots where those that were willing could experiment, fail fast, build on successes, and build a digital culture. Through some breakthroughs use cases and financial return prioritization, the company overcame internal resistance, found their way to a model that didn't demand standardization, allowed local innovation and ownership and built a digital community that acted like a tech start-up as much as a brewing company.

Many leaders recognize that their organization's corporate culture needs improvement but don't know where to start. Research on unhealthy corporate cultures points to toxic leadership, toxic social norms, and work design as the three most powerful predictors of toxic workplace behavior. The authors explore evidence-based interventions, organized around these key drivers of toxic culture, that leaders and companies can use to retain employees and create a more positive workplace culture.

The OneMotoring portal is a one-stop gateway to vehicle-related services and an integral resource for the motoring community in Singapore. From real-time traffic updates to renewing road tax, paying transport-related fees, and supporting the entire lifecycle of vehicle ownership, the portal offers more than a hundred digital services delivered by the Land Transport Authority (LTA), the government agency overseeing land transport in the country. In the early 2000s, LTA was among the forerunners in the digitalisation of public services and had battled its fair share of challenges commonly encountered by agencies embarking on a digital transformation journey. Users' lack of computer literacy, the loss of human touch in service delivery, the difficulty in authenticating user digital identity, and workforce transition were among the common pertinent issues. Through stakeholder engagement, work redesign, employee retraining, leveraging government-wide shared services, and active partnership with multiple entities, LTA had succeeded in surmounting those obstacles. While the portal continued to serve and meet most of the motorists' needs, LTA did not rest on its laurels. Moving forward to 2022, LTA saw the opportunity to push the envelope further to serve motorists better. In the pipeline was a new round of system upgrades, which included the evaluation of newer technologies to speed up the delivery of services and policy changes. With so many digital possibilities presented by technological advancements, how best could LTA reimagine the delivery of vehicle services from the future of mobility perspective?

Shanghai Forest Cabin Biotechnology Co., Ltd. (Forest Cabin) was a skin care product manufacturer and retailer that had focused on developing offline stores. At the beginning of 2020, however, the onset of the COVID-19 pandemic stagnated offline sales activities. Half of Forest Cabin’s offline stores closed at that time, and the existing stores had few customers, slowing the offline sales business. Forest Cabin rapidly initiated live streaming sales based on the digital foundation the company had built in its earlier stages. In this way, the company successfully responded to pandemic-related challenges and gained user traffic to realize revenue growth. However, with COVID-19 slowing down, people were resuming offline activities. Forest Cabin’s offline stores had provided a competitive advantage to the company. But the company had been able to leverage online live streaming, bringing explosive growth and enabling the company to survive a crisis. Should Forest Cabin focus on online development or offline development going forward?

The case follows the debt restructuring of WorldStrides International, a travel program provider in the education market, after the onset of COVID-19. The pandemic severely impacted the travel industry, creating challenges for many companies like WorldStrides, which were highly-levered and whose debt was held by a wide range of institutional investors, including collateralized loan obligations (CLOs). By May 2020, WorldStrides needed to restructure its debt, and there are two proposals that are being circulated, one from the company's private equity sponsor and the other from a hedge fund holding some senior secured debt. This case takes the perspective of York Capital Management, a CLO manager that also holds WorldStrides's senior secured debt. Both existing proposals had aspects that would have put stress on the structure of York's CLOs at the time. This case takes a deep dive into the economics of CLOs and their internal compliance processes. With this information York's CLO team needs to suggest to their lending group whether to accept either proposal, look for other options, or sell the loans at a loss and redeploy the capital. This case can be used as a background for teaching corporate debt securitization, corporate debt restructuring, and the role of creditors that face different institutional constraints.

Indiagro is a national-level farmer produce company (FPC) primarily operating in the government-to-business (G2B) segment. The National Agricultural Cooperative Marketing Federation of India Ltd. (NAFED) and the Department of Consumer Affairs have appointed Indiagro to procure 10,000 tonnes of onions from the Bhavnagar and Amreli districts in Gujarat under the Price Stabilisation Fund (PSF). This case discusses the challenges Indiagro's chairperson, Padma Shri Genabhai Patel, faces at different levels of onion procurement. Since onion is a perishable commodity, this process has its own set of dynamics and complexities. The case tries to examine how Indiagro managed its supply chain operations and developed its systems and processes around these complexities. It focuses on the substantial role Indiagro plays in filling the institutional voids in the agricultural commodity markets in India. It helps understand the value created by Indiagro for its member farmers compared to when they operate individually or through the Agricultural Produce Market Committee (APMC).

The U.S. Supreme Court decision that overturned Roe v. Wade in late June is affecting some employees' decisions about where they want to live and work. As some states pass laws to ban or restrict access to abortion services, employers' responses may affect their ability to attract and retain top talent. The authors offer five actions organizational leaders can take to support and protect employees' reproductive freedom in light of some states' changing reproductive health care policies.

Ajith Rai hailed from a humble background. As a first-generation entrepreneur, over the last three decades he had built a successful automotive business under the umbrella of Suprajit Engineering Limited (SEL). Rai and his wife, Supriya, along with their three sons were a close-knit family. The two older sons were deeply involved in the family business, and the third son was close to finishing his engineering studies. Supriya, a dentist, was engaged in the philanthropic activities of Supriya Foundation, the corporate social responsibility (CSR) arm of the business. Rai had seen many business families disintegrate for lack of governance, and hence early on in his business career, he decided to formulate a family constitution. His sole objective was to safeguard family kinship and business longevity. The case reveals not only the process adopted by Rai to formulate the instrument of family governance-the family constitution-but also his ability to focus on building the capacity of all family members. The case closes with Rai reflecting on the satisfying journey thus far and hoping that the family constitution will be comprehensive enough to take care of the conflicting scenarios that could arise in the future.

Shanghai Forest Cabin Biotechnology Co., Ltd. (Forest Cabin) was a skin care product manufacturer and retailer that had focused on developing offline stores. At the beginning of 2020, however, the onset of the COVID-19 pandemic stagnated offline sales activities. Half of Forest Cabin's offline stores closed at that time, and the existing stores had few customers, slowing the offline sales business. Forest Cabin rapidly initiated live streaming sales based on the digital foundation the company had built in its earlier stages. In this way, the company successfully responded to pandemic-related challenges and gained user traffic to realize revenue growth. However, with COVID-19 slowing down, people were resuming offline activities. Forest Cabin's offline stores had provided a competitive advantage to the company. But the company had been able to leverage online live streaming, bringing explosive growth and enabling the company to survive a crisis. Should Forest Cabin focus on online development or offline development going forward?

Startups are often evaluated by how well they perform on unit economics, defined as the ratio of a customer's lifetime value (LTV) to acquisition costs (CAC). A common target for unit economics, advocated by many VCs and analysts, is 3:1 (i.e., LTV/CAC=3). While there is certainly appeal to having a relatively high unit economics - and it provides the firm with a guide on how much to expend on acquiring customers - it is not obvious whether this prescribed "rule of thumb" ratio is in the firm's best interest. This note analyzes the problem by exploring how a company should go about determining the optimal amount to expend on customer acquisition. The approach proposed, in effect, calls for maximizing customer equity (the sum of lifetime values gained from all customers that are acquired less the acquisition costs incurred) and takes into account that there are decreasing returns to marketing efforts. The resulting customer unit economics (referred to in this note as CUE for short) is shown to often be lower than 3:1 - suggesting that firms have more leeway to grow while at the same time being mindful of profits.

The case is set in the fall of 2022. The protagonist is Barry McCarthy, who replaced John Foley, Peloton's founder, as CEO earlier that year. Peloton Interactive, Inc. (Peloton) is a fitness and media company specializing in internet-connected exercise equipment such as stationary bicycles and treadmills. Over the 2018-2021 period, Peloton grew its revenues at a compound annual growth rate (CAGR) of 110%. Yet, by 2022, Peloton was in crisis. Total revenues remained flat at $3.6 billion, and Peloton lost almost $3 billion that year. Its market cap had fallen 94% from a peak of nearly $50 billion (2021) to less than $3 billion (2022). Barry McCarthy's strategic intent is to pivot Peloton to a subscription-based content business. Previously, when serving as chief financial officer at Netflix and Spotify, Barry McCarthy successfully implemented a content-based subscription model. Can he achieve similar success at Peloton?

On November 2, 2021, Enrique Lores, CEO of HP, Inc., ended the first online huddle of the week with his executive leadership team. The day was an historic one for the Palo Alto-based global company: six years earlier, HP Inc. came into being after the split of the iconic hardware company into two: HP, Inc. and Hewlett Packard Enterprise. As soon as Lores, who had become CEO the year prior, took over the reins at HP Inc., he immediately began to strategize the aggressive transformation of the hallowed company from a product-oriented to a customer experience-oriented company, identifying three areas, each requiring significant innovation: 1. Evolution of core business models to adapt to changing customer needs; 2. Pursuit of adjacencies in relation to the personal computer and print businesses; and 3. Leveraging platforms (capability and asset) and software assets to create new businesses. The broad and deep change initiative that he had charted for HP would require changes in skills, talent, infrastructure, and culture. To communicate what was required of his team, shift their thinking, and achieve a better multiple on their earnings per share, Lores asked his leaders to focus their attention on three key concepts: (1) Advance the business models of HP's core businesses; (2) Disrupt using HP's core assets; and (3) Transform the processes, cost structure, go-to-market capabilities, supply chain and brand of HP. Perhaps unsurprisingly, discussions at the morning meeting centered around the need to harness the past and drive the future. Markets were changing, HP's performance was accelerating and the company was seeing new customer behaviors. In addition, there was an inflection point in the PC stack and importantly, 3D printing, where HP had a great position, was attracting a lot of interest.

After sourdough bread, countertop chive gardens, and vaccine selfies came a pandemic-era trend that everyone seemed to be in on: one daily chance to guess a five-letter word and crow about your success on social media via little green and yellow squares. From a personal game between a developer and his girlfriend to a global phenomenon in just a few months, Wordle seems poised to outlast its pandemic peers when The New York Times makes an unexpected bid to acquire it. Dissect the journey of one programmer and his viral product as he debates a 7-figure exit before earning his first dollar of revenue.