A first-in-kind assessment of $17.4B USD in Generational Health entities, by total funding raised. Revealing why a Generational Health strategy is principally valuable both in returns and for society.

Foreward

To our respected colleagues, partners, friends and audience,

It is vital to understand the intersections of Generational Health with critical outcomes sought by industry, markets, and countries. The effects on the health of the planet and human physiology can no longer be ignored. Generational health represents a cross-sector opportunity, providing an economic view of the health effects collectively passed onto humanity.

Tower Capital Group LLC. or “TOWER” is the pioneer in exploring the market and portfolios of Generational Health entities. It is our mission to coalesce public and private stakeholders towards focused action into the category of Generational Health.

This report demonstrates a first in kind assessment of $17.4B USD in entities, by total funding raised, representing Generational Health. It reveals the many reasons why a Generational Health strategy is principally valuable both in returns and for society.

It represents a new set of actions towards defining, understanding, and together growing a critical market. It supports innovations and entities that demonstrate performance value with the ability to deliver solutions to society’s challenges. Many have turned their attention to impact investing, yet this does not inherently create a generational flywheel.

Though there is more to uncover, in both impact and performance, Generational Health is a wise opportunity. TOWER brings the first of this class to the forefront and we look forward to unlocking its potential with you.

With Gratitude,

Sanskriti Thakur, Chairman & CEO

Vani Rao, President

"Create a generational flywheel."

SUMMARY POINTS

This report demonstrates a first in kind assessment of $17.4B USD in entities, by total funding raised, representing Generational Health. It begins to reveal the many reasons why a Generational Health strategy is principally valuable both in returns and for society.

• Curates the first investment cohort based on the ability to measurably improve health effects passed onto next generations, under the definition of Generational Health provided herein, and the underlying economic drivers.

• Offers a lens to aggregate entities falling into the categories of environment, community, and women’s health. Actions untapped economic potential, by demonstrating the intersection with key growth horizontals in technology, consumer, and industrials.

• Shapes a diversified investment basket, across 8 industry sectors, 14 industry groups, and 5 funding stages.

• Opens doors to value propositions in: Longevity & Human Quality of Life, Reproductive Innovations & Capacity, Care Systems Disruption, Toxicity Elimination & Decarbonization,, Technology Equity inc.Mobility & Last Mile Access.

• Bridges demands from private sector and public sector to the supply of problem solving innovation to ensure human health effects of strategies and policies are considered in mission critical decisions.

1 Introduction to Generational Health

In 2018, the National Academies of Science Engineering and Medicine published a consensus study report in which they defined a framework for Generational Health, simplified and adapted as: those health effects passed on genetically, epigenetically and/or environmentally to future generations.(1) The publishing committees were acting upon the need to understand multi & trans generational impact on veterans and children of war and conflict. Multiple factors with potential to shape future generations were considered. The evolution in precision science and within genetics and epigenetics continue to enlighten the body of research. These factors are foundational to Generational Health.

Today, as large parts of the globe undergo conflicts, this study serves as a baseline for understanding of the historical and the probable. TOWER leverages this robust research and, with it, shapes a market strategy. It broadens the view beyond war and into daily life where these challenges to human physiology penetrate. It deepens the focus on prevailing environmental toxins, the rise of mental health crises, and inequity within communities, women and children.

With this focus, TOWER identifies the opportunities and entities that strictly bring solutions that directly impact Generational Health effects passed onto the future. It requires that each entity demonstrates strong likelihood to create returns. Without this, Generational Health will not sustain amongst the fads, and cynics.

The Science Around Generational Health

Literature analyses across approximately eighty thousand scientific papers, as described thoroughly by the National Academies 1, and adapted below, categorizes the scientific areas of focus as follows:

1. Reproductive effects: any effect on the ability to reproduce. Including, effects on male reproduction, such as changes in sperm parameters and reproductive hormones, infertility, time to pregnancy; effects on female reproduction, including those on menstrual cycle, endometriosis, in-fertility, time to pregnancy, changes in reproductive hormones; adverse pregnancy outcomes, including the spectrum of pre-post maternal health, such as gestational diabetes, gestational hypertension, and inflammation during pregnancy; and birth outcomes, such as preterm birth, birth weight or size, spontaneous abortion, and still-birth.

2. Developmental effects: any adverse health effects in children or offspring of any age, including reproductive effects. Neurodevelopmental deficits, including measures of cognition (IQ, attention, motor skills, etc.), autism spectrum disorders, attention deficit disorders; respiratory effects, including respiratory symptoms (e.g., wheezing), lung function, asthma, respiratory infections; childhood cancers; birth defects; Immune outcomes: eczema, dermatomyositis; obesity and metabolism; and growth.

3. Epigenetic and genetic effects: including markers of DNA oxidative stress; DNA methylation in maternal blood, umbilical cord blood, placenta, or peripheral blood lymphocytes, sperm; mRNA expression; Histone modifications; and Mitochondrial DNA content in umbilical cord blood.

Across all stages, exposure in the environment is considered. When science extrapolates to markets, we propose that in simple terms, three main areas intersect: Environment, Community, and Women. In totality, it is notable that they sum up to overall impacts to human longevity, quality of life and reproductive capacity.

"Generational Health, simplified are those health effects passed on genetically, epigenetically and/or environmentally to future generations."

In prioritizing Generational Health, we can:

1. Strengthen Defense. 77% of Americans ages 17 to 24 are unfit for military service, primarily due to obesity, mental health disorder, substance abuse, and physical disability. By addressing communities through Generational Health, we can begin to ensure our nation is sufficiently able bodied to keep us safe.(2)

2. Prevent Rising Maternal and Infant Mortality. Despite having one of the most advanced health systems in the world, female and infant mortality rates are increasing in the United States. Supporting Generational Health offers a myriad of ways this trend can be reversed.(3)

3. Enable Access to Clean Water for Rural Populations. Violations in water quality standards occur disproportionately in rural communities. 93% of the 60,000 community water systems in the US impact rural communities of 10,000 people or less. It is well documented that water shortages and contaminations create multi-generational damages. Linking these problems with the health effects through Generational Health can uncover lasting solutions.(4)

4. Unlock Women’s Health. No longer can women’s health stand aside as an understudied, underfunded area. Not when science tells us about the critical importance of their role in the arch of generations.

5. Reduce the Impacts of Discrimination. Enable culturally sensitive care models to be delivered and adopted by diverse populations allowing for mental health services to be accessed at lower costs and and greater reach.(5,6)

Generational Health is not merely a focus on the most egregious health concerns; healthier populations are the way to boost GDP and productivity exponentially.

Together, these are particularly relevant due to high unmet need, strong consumer power, access, influence driving increases in demand, and rising potential for advancement in technology and innovation.

2 Framing the Market

With such a value proposition to bear, and supported by activities of large industry, siloed sector investing has muddied the greater opportunity in Generational Health.

The global markets in environmental sustainability, health and life science, and technology, all play a role in the shape of Generational Health. With trillions of dollars moving into these categories, relatively little is strategically invested into Generational Health. The loss of value is likely both economic and humanitarian.

The missed opportunity slows growth potential. It may overlook structural inefficiencies, such as disparate data systems, and prevent the unlocking of Generational Health as a category where irrefutable relationships exist between environment and human health.

TOWER’s approach allows a focused framing of the Generational Health market for intentional capital infusion. The primary decision lever is direct and meaningful activity towards Generational Health. In this perspective, TOWER identifies a market basket or cohort of over 400 entities totaling $17.4B of current invested capital.(7) These entities qualify due to their explicit compliance with the stated definition of Generational Health. This collection represents the first identified, vetted and curated cohort of Generational Health entities in the market.

Leveraging the Global Industry Classification Standard (GICS) global guidelines, the Generational Health market cohort covers 8 industry sectors and 14 industry groups. The top three industry groups represented are: Pharmaceuticals, Biotechnology & Life Sciences (32%), Health Care Equipment & Services (26%) and Utilities (13%). The balance is split across multiple categories including: Software & Services, Consumer Services, Transportation, Household & Personal Products, and Materials. Identifying limitations of GICS based analysis alone, technology is represented across more than 50% as a horizontal sector.

As part of the Addendum of Methods, all entities were initially sourced via global syndicated data sets, searched across generalized industry groups , and then aligned with the Generational Health scientific framework.

"Crossing Environment, Community & Women, diversified across 8 industry sectors and 14 industry groups."

3 Industry & Category Intersections

Despite the industry diversity represented in the market basket, the definition of Generational Health can be actually be leveraged to focus and drive outcomes. The relationship across generational health entities can be viewed in four ways. 1. Scientific Effect, 2. Generational Health Categories, 3. Industry Sector, and 4. Industry Group. It is notable that in the curation of TOWER generational health market basket and investment evaluations, tiers like “Tobacco” were eliminated due to their detriment to Generational Health. Nevertheless, the below demonstrate a traditional alignment, and supports the necessary curation of a better view.

Generational Health Categories:

Upon viewing all entities selected based on definition, three areas of focus emerge from the science .In order to speak to the general public, they can be simplified as: environmental reduction of toxicity, community health, and women’s health.

Environmental

There are hundreds of identified environmental toxins that measurably damage physiology, decreasing vitality, and increase risk of disease. If acted upon, the damage reversed.(6) Environment-focused Generational Health entities represent 31% of evaluated entities and received 44% of funding. Environmental focus appears across nearly all elements of scientific effect: Reproductive, Developmental and Genetic/Epigenetic factors. It is represented across 7 Industry Sectors and 11 Industry Groups.

EXAMPLE: Companies focused on biochemical conversion, such as those innovating in carbon removal are ultimately focused on the management and elimination of waste products that result in health toxicity. For example, entities are innovating around CO2 electrocatalysis and electrochemical reactor design to eliminate industrial emissions and reduce CO2 in the atmosphere. This mission is ultimately about human health and the removal of emissions that have toxic effects on the populations with generational consequences.

Community

The focus area of Community is tied to the systems of support, connectivity, health services and offerings that are required to persist for population health. These also serve to ensure access to mental health, pediatric health, and veteran health. Importantly, this area plays an integral role in the outcomes associated with lifespan and longevity from a population health perspective.

Community health focused Generational Health entities represent 50% of evaluated entities and received 50% of funding. Community Health directly addresses all three scientific effects: Reproductive, Developmental and Genetic/Epigenetic factors. It is represented across 8 Industry Sectors and 9 Industry Groups.

EXAMPLE: One notable focus is around entities innovating in remote monitoring of breath and lung capacity to support disparate populations with limited proximity to health services. These include those at risk due to known chemical exposure due to environmental toxicity, families with children suffering from chronic illness, and soldiers in combat under life threatening conditions.

Women

The focus area on Women’s health fills a critical gap in underfunded research and understanding that penetrates global society. With the scientific reality that the female reproductive system and genetic passage is more susceptible to environmental challenges and that reproductive shifts can pass onto the fourth and fifth generations, female biology is disproportionately important to positive Generational Health and evolution. As more than 50% of the population and custodians of care, an emphasis on women is critical.

Women’s health focused Generational Health entities represent 19% of evaluated entities but only 5% of funding. The relationship of Women’s Health to all three scientific effects in irrefutable. It is represented across 4 Industry Sectors and 7 Industry Groups.

EXAMPLE: A leading innovator category in women’s health and precision medicine focuses on the untapped space of female specific microbiome - providing solutions such as at-home tests for individualized care and longevity. Companies operating in this space stand to provide the infrastructure to close the gender health gap through metagenomic sequencing, an untapped accelerator for women’s health innovation.

Equally important are the industry intersections

Health and Life Science predominates and represents critical genomic, disease, preventative and innovative solutions in diagnostics, treatment, and monitoring. Consumer offers solutions bring in generational health closer to home or communities, or embedding across other consumer offerings. Software & service led companies, based on business model, represent 36% of the entities in Generational Health. This may be critical to solving for better data, prediction, filling access gaps, ensuring digital connection and bringing Generational Health solutions to humanity. Industry verticals are diverse and horizontals support cross-sector applications and scale. The industries intersect at important points to the benefit of Generational Health entities. These are further discussed as “themes”.

"Software & service led companies represent 36% of the entities in the Generational Health cohort."

4 Early Understanding of Investability and Value

Critical to Generational Health is its investability.

To further explore investability, innovator entities are also evaluated for impact and growth based on a scoring system (reference methods). By identifying outliers on both positive and negative spectrums, the dynamics of the innovator category can be understood.

Leading entities are likely to achieve scale are considered high growth and high impact. They have not only raised capital within the last year, but have managed to increase in valuation by at least 2X between capital rounds.. These companies have raised an average of $47M and have achieved an average valuation of $150M. Most of these entities expect either a direct or scaled human or planetary outcome.

Entities scoring in medium-high growth are the majority, demonstrating their upside potential amidst the need to navigate awareness, funding and principled management. Importantly, they may not be taking full advantage of their Generational Health value proposition as many are tailor tacked to siloed industry strategies.

It is notable that very few entities are both low impact and low growth. Even in this category they demonstrate above average potential and should be further evaluated.

Shortening the horizon

Generational Health considers not just what needs to be funded in the future, but also identifies immediate unmet needs that have budgets to be met now and in the near term. The ability to dynamically consider duration improves category liquidity and derisks the investment opportunity. Enacting across a three part horizon, allows for multiple stages of value and expects shortened horizon for returns.

To consider timeline to value creation and economic return, the Generational Health cohort was classified into funding stage and source: Early Stage VC (52%), Late Stage VC (15%), Strategic (3%), Public (1%), and Non-Dilutive funding (30%). Innovators are a subgroup of the larger cohort. It is notable that although mature private and public companies exist within Generational Health, they require further study and were excluded from this cohort analyses. In the future, they will be included where liquidity is required in a Generational Health financial product.

This breakdown is critical to our understanding of the next phase in Generational Health as the cohort is comprised of products and services that range in time to delivery. As expected, more than half of companies have received early stage funding while notably, another 19% have achieved material capital events. More entities will be positioned to evolve to later stages with a Generational Health focus.

Of significance to the category however, is access to non-dilutive funding mechanisms including grants and structured debt representing important funding sources to this market.

Diversification across stages of maturity allows for greater balance in both supporting innovation and achieving economic returns. With over half the cohort still in early stage there is an opportunity to be ahead of the curve.

Value Propositions

Across innovative entities, industry intersections create important value propositions. These represent emerging business models and help shape an investment framework around Generational Health.

They cluster around five main themes:

• Longevity & Human Quality of Life

• Reproductive Innovations & Capacity

• Care Systems Disruption

• Toxicity Elimination & Decarbonization

• Technology Equity with Mobility & Last Mile Access

These themes are relevant across the Generational Health cohort. Opportunity remains in particular categories that are under-represented. For example, microbiome protection, mitochondrial DNA protection, pediatric and aging innovations and others. They are high value and under-represented in the available pipeline of innovation. Cultivating these further may be a differentiator for an investment approach in Generational Health.

"Leading themes include:

Longevity & Human Quality of Life

Reproductive Innovations & Capacity

Case systems Disruption

Toxicity Elimination & Decarbonization

Technology Equity with Mobility & Last Mile Access."

5 Closing

Accelerating value creation through the lens of Generational Health is an opportunity to engage cross-sector action, scientifically and through investment, to create market opportunity and returns while meeting today's needs for human and planetary health.

This perspective offers a gateway for market participants in the private and public sector to participate in Generational Health. It lays groundwork for mechanisms to fund the opportunity with intentional focus on the themes and categories addressed.

The Industrial Revolution has demonstrated detrimental impacts to human life and demographics when health is not considered alongside advances in technology. As the world considers energy transition today, human health must be prioritized. Generational Health offers an investable means to participate in positive outcomes.

Intuitively, the stability of a community is integrally related to the health of those within the community and their relationship to one another. When communities destabilize, the potential outcomes become unpredictable. Global conflict is already increasing mortality rates worldwide. Generational health provides an approach to community health not only through support to those already victim to war but offers policy makers globally an economic approach to preventing the instability from spreading further worldwide.

As global demographics are fundamentally shifting, reproductive health and capacity, continue to lag due to lack of private and public sector investment and focus. However, with the lens of Generational Health, market participants and public sector can fundamentally support optimal outcomes, while closing the significant and persistent gap in women’s health, which should be recognized for its untapped upside.

Previously inaccessible as a curated option, all market participants may consider this approach as a means to deploy capital within the emerging Generational Health flywheel.

SUMMARY POINTS (RESTATED)

This report demonstrates a first in kind assessment of $17.4B USD in entities, by total funding raised, representing Generational Health. It begins to reveal the many reasons why a Generational Health strategy is principally valuable both in returns and for society.

• Curates the first investment cohort based on the ability to measurably improve health effects passed onto next generations, under the definition of Generational Health provided herein, and the underlying economic drivers.

• Offers a lens to aggregate entities falling into the categories of environment, community, and women’s health. Actions untapped economic potential, by demonstrating the intersection with key growth horizontals in technology, consumer, and industrials.

• Shapes a diversified investment basket, across 8 industry sectors, 14 industry groups, and 5 funding stages.

• Opens doors to value propositions in: Longevity & Human Quality of Life, Reproductive Innovations & Capacity, Care Systems Disruption, Toxicity Elimination & Decarbonization,, Technology Equity inc.Mobility & Last Mile Access.

• Bridges demands from private sector and public sector to the supply of problem solving innovation to ensure human health effects of strategies and policies are considered in mission critical decisions.

supporting discussion of demand and supply

There is great demand for Generational Health, with supply in innovative stages.

Consumer Demand

Many facets of consumer demand exist., As an example, it continues to be relevant that the COVID pandemic accelerated the adoption of digital health services and tools. Consumer demand for high quality digital health experiences are increasing where consumer health expands beyond tele-health and includes precision medicine, patient support, and treatment adherence.

57% of consumers are open to remote monitoring of ongoing health issues through at-home devices - this offers unprecedented access to data for advanced research, encourages treatment adherence in the comfort of one's homes supporting aging in place trends, and can deliver crisis prevention solutions. 68% of people are more likely to choose a medical provider who offers the ability to book, change, or cancel appointments online - identifies that the need is not about accessibility to health care alone but also the adoptability of healthcare, to reach those who may benefit from it the most. (10)

54% of U.S. consumers prefer targeted health care advertising because targeted messaging is more relevant and adds more value. This represents the demand for precision medicine at the individual level. This phenomenon is exemplified in women’s health, where traditional funding systems have failed to address the health and wellness needs of women. As a result, women are addressing their unmet needs at the consumer level. (11)

Innovators are Driving Supply

While general healthcare innovation, microbial science, and collaborative open data models have demonstrably impacted lifespan, quality of life considerations lag. Economies have not ignored the opportunity. Senior living is a mature subset of the real estate market. Lagging however, are health assistance, family support, and care navigation models where technology now exists to accelerate quality of life and longevity. These points are supported by the data set evaluated in this perspective.

Healthcare navigation is a persistent theme in private sector activity. 2023 saw consolidation of healthcare navigation service providers, particularly through non-scalable human delivery models. However, there is an emergence of care navigation services, particularly through specialty services like maternal care management and chronic care support. Use of tele-health in the delivery of community health services went from 43% pre pandemic to 99% post pandemic. As technology continues to expand and deliver scalable solutions at a more efficient cost, we can expect comparable consolidation to occur across digital platforms. (12)

As governments grapple with changes in population sizes and demographics, reproductive capacity expands from a women’s health issue into concerns of national interest. Unlocking reproductive innovation through the lens of generational health is an imperative for human rights and stands to unlock unprecedented levels of productivity to increase GDP.

In anticipation of this effect, VC funding towards women’s health has outpaced that of overall healthcare in the last 5 years. However, women’s health funding at the seed stage saw a 20% lower valuation than general seed stage health funding.(13) This suggests that women’s health entities can still be acquired at a discount relative to general healthcare entities but that the market momentum exists to deliver outsized and earlier returns. With policy directives expected to emerge from the White House Initiative on Women’s Health Research in the US, resulting regulatory shifts should bolster spending in women’s health innovation.

Synergistic health and climate investments are at a nascent stage. Unlike agriculture, transportation, and energy, the health sector has not yet mobilized climate funding. Large investment has been made into precision farming to reduce the toxic waste byproducts in agriculture yielding massive economic return. Acquisition in the electric vehicle industry, charging and support, ran rampant in 2023. In climate, the carbon dioxide utilization market alone is projected to approach $10 Billion USD at the end of the current decade. (14,15)

Ultimately, the relationship between health and climate is irrefutable. So how does the market, supporting a capital intensive industry, know that the toxins removed have any effect on human health? The lens of Generational Health is an approach to address this gap, offering a way to identify and ultimately support the innovations with the greatest health impact.

Private Markets

The overarching private participants are increasingly prioritizing the demand for human sustainability through investment. The size of the market for sustainable investment has been increasing, with momentum for an exponential surge, but a shake out driven by regulatory requirements from the SEC in September 2023 has shifted the sustainable investment landscape. In the United States (US), this has created an investment opportunity for a better understood, scientific-based approach to investment.

In the US, regulatory clamp down on what constitutes ESG - SEC “Names Rule” in the Investment Act on the use of the “ESG” identifier after concerns about greenwashing highlight the importance of focusing on a scientifically understood category that considers health impact of humans and planet generationally. (9)

While outside the US, the global market for sustainable investments continued to grow at 20% YoY to $30.3 Trillion USD, the US saw declines in ESG investment from $17.2 Trillion USD in 2021 to $8.4 Trillion USD in 2022, in assets, in anticipation of regulatory changes. With regulatory clarity, the motivation and intention towards sustainable investment should resume, with emphasis on transparency and credibility. (10)

Public Markets

Even prior to a year of escalating global conflict, governments recognize the need to better support the populous. In the US alone, in response to the unmet need for dramatic changes to improve equitable outcomes, government spending in Generational Health initiatives has increased to unforeseen levels, driven in large part by the Inflation Reduction Act of 2022. Examples include:

• $27 Billion in Green Gas Reduction Fund from US Environmental Protection Agency

• $10 Billion Tech Hub Program, of which $500 Million appropriated to the US Economic Development Agency to launch in 2023

• $2.5 Billion in Advance Research Projects Agency for Health

• $4.5 Billion anticipated by the CDC to continue supporting data modernization necessary for public health and safety

• $1 Billion in 2024 and steadily increasing since inception, is budgeted by the National Institute of Environmental Health Services(USD).

About

TOWER CAPITAL GROUP LLC, is an economic development entity responsible for defining, developing and funding the category of Generational Health.

Generational Health are those effects passed on genetically, epigenetically and environmentally, shaping humanity's evolutionary curve.

These effects are scientifically and systemically measurable. They represent a multi-trillion dollar opportunity for both the public and private sector growth.

Operating across industries, regions and partners, TOWER and its affiliates deploy expertise and capital to uncover economic value, investment and innovation within Generational Health and bring it to stakeholders across the globe.

The intent of this report is to help parties understand the definition, value and outcomes delivered with Generational Health to markets and for humanity.

Contributors:

Mariana Ducu

Senior Investment Associate

Callie Estreicher

Data & Analysis Fellow

Acknowledgements:

To our trusted advisors, fund managers, generational health change-makers and partners who have taken the time and effort to review and provide critical feedback, ideas, and inspiration.

Copyright 2024. TOWER CAPITAL GROUP

This content is being shared for informational purposes only and is subject to change.

©2024 TOWER CAPITAL GROUP LLC. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, including photocopying and recording, or by any information storage and retrieval system.

Methods, references are best viewed in desktop mode.

ADDENDUM OF METHODS

• Definition: In order to baseline the market on a published definition of Generational Health, the National Academy of Science 1 library was utilized. In particular, both the framing of Generational Health and the scientific categories best associated with it.

• Global markets categories: With a top down approach, leveraging the Global Industry Classification Standard (GICS) market categories, the scientific groups, products and services were best matched to current mature market sectors, industries and sub groups. The totality of these, enable a baseline framing of the industries and sectors of focus in Generational Health, that match the science of Generational Health effects.

• Private entity analysis: Private entities were clustered into their primary areas of focus, broader than industry or sector grouping. This approach focused on areas of environment, community (including mental and pediatric health), and women’s health. These focus areas, which are broader than industry, enable the general public understanding.

• Syndicated data review: Private entity, and products analyses were conducted by multimodal research across vetted syndicated data sets including: Crunchbase, Pitchbook, etc. Dated December 2023.

• Primary research: Primary research was conducted to fill data gaps and validate information where inconsistency was recorded.

• Selection for inclusion as Generational Health entity: All entities are rigorously evaluated for their direct impact to Generational Health across the researched scientific stage of reproductive effect, development effect and or genetic/epigenetic effect. Further environmental relevance was addressed.

• Specifications of Generational Health focus areas and categories: Each entity was evaluated against the scientific definition of effect, matched to a traditional industry and then assigned a focus area (Environment, Community and Women).

• Generational Health focus areas were further deconstructed into 11 sub-categories that also independently align to industry categories. Further, each entity was matched to these sub-categories.

• Consideration of themes and intersections: These were evaluated based on the entity’s business model and stated activity. Value propositions were determined by the outcomes the entity presented as either achieved or expected to achieve.

• Consideration of the entity stage: Based on the last funding round type as reported by Crunchbase and further validated by primary research, as needed, individual entities have been assigned a specific Innovator stage, ranging from Early Stage VC (Pre-Seed, Seed, Series A, Convertible Notes, Equity Crowdfunding), Late Stage VC (Series B+), Strategic (Private Equity, Corporate Round), Public (post IPO), Non Dilutive (Grant, Non-equity assistance, and debt) and Other (Series Unknown or Not Disclosed)

• Consideration of market basket cohort & innovator group: General health entities that have received capital funding were considered for the purposes of category evaluation making up the market basket cohort. All entities defined as innovator group have been validated to fall into the definition of Generational Health.

• Consideration of investors: Based on entity stage, investors participating were mapped, to better understand investment flows.

• Impact and Growth Scoring for innovator cohort:

  • Evaluation of growth. The methodology classifies entities into five scored categories based on their operational and capital-raising activities and estimated growth potentials across multiple markers.

  • Evaluation of impact: The methodology classifies entities based on impact as defined across both human and planetary outcomes, also with a five category scoring model.

• All additional estimates are based on the dynamics of either the market basket cohort or the innovator cohort, as compared to industry baselines or practice.

• All retrieved data is within the period of September 2023-December 2023.

These summary methods serve to provide a view into the TOWER methodologies to define and evaluate Generational Health. They are not exhaustive

SUMMARY OF ENDNOTES

Full references and additional information available by request. References are publicly available documents or articles, with the exception of purchased syndicated data leveraged as input into meta-analyses, modeling and analyses.

1. National Academies of Sciences, Engineering, and Medicine. 2018. Gulf War and health, volume 11: Generational health effects of serving in the Gulf War. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/25162.

2. https://americanmilitarynews.com/2023/03/77-of-young-americans-too-fat-mentally-ill-on-drugs-and-more-to-join-military-pentagon-study-finds

3. https://www.yalemedicine.org/news/maternal-mortality-on-the-rise#:~:text=Maternal%20mortality%20has%20been%20rising,2020%20and%20754%20in%202019

4. https://www.americanbar.org/groups/crsj/publications/human_rights_magazine_home/vol--44--no-2--housing/rural-america-s-drinking-water-crisis/

5. https://www.healthaffairs.org/doi/10.1377/hlthaff.2021.01422

6. Faroon O, Roney N, Taylor J, Ashizawa A, Lumpkin MH, Plewak DJ. Acrolein environmental levels and potential for human exposure. Toxicol Ind Health. 2008;24(8):543-564. PMID:19039083 doi:10.1177/0748233708098124

7. https://www.gatesfoundation.org/ideas/articles/womens-health-economic-power

8. Meta-analyses of syndicated data and primary data conducted by TOWER CAPITAL GROUP, dated December 2023.

9. Multiple public sources and reference to grants and funding directed by the US government

10. https://www.spglobal.com/marketintelligence/en/news-insights/latest-news-headlines/even-as-esg-market-narrows-money-managers-in-the-space-prioritize-climate-73499895

11. https://www.gsi-alliance.org/wp-content/uploads/2023/12/GSIA-Report-2022.pdf

12. https://newsroom.cigna.com/15-stats-demonstrate-rising-consumer-demand-for-digital-healthcare-experiences

13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6591259/#:~:text=An%20axium%20attributed%20to%20Benjamin,benefits%20to%20society%20(1)

14. https://www.nature.com/immersive/d41586-023-01475-2/index.html

15. https://globalhealthsciences.ucsf.edu/sites/globalhealthsciences.ucsf.edu/files/climate_and_health_finance_final.pdf