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Survivability capital is a unique resource resulting from the “familiness” constituting an inherent feature of family firms. Familiness represents the ability of family members to reinforce the financial and non-financial resources of businesses facing threats to their economic existence. This work proposes and examines various dimensions of the survivability capital construct, verifying whether family firms expecting deterioration of their economic situation or problems with survival due to the COVID-19 crisis can mobilise sufficient capital to survive.

This article provides empirical evidence based on a cross-sectional online survey of 167 Polish family firms, conducted at the beginning of the COVID-19 pandemic. The method (scale) of survivability capital measurement was elaborated and validated using principal component analysis (PCA) and confirmatory factor analyses (CFA). Next, the mobilisation of the different dimensions of survivability capital was examined using PLS-SEM modelling.

The survivability capital of family firms is composed of two dimensions: internal (based on directly involved family members) and external (based on not directly involved family members). Family firms facing crisis-induced deterioration of the economic situation engage its internal component. Subsequently, family firms forecasting decreasing probability of survival during a crisis try to engage both the internal and the external components of survivability capital. Such behaviour is in line with the resource-based view as well as with the sustainable family business theory.

To the best of the authors' knowledge, this is one of the first studies to examine analytically the survivability capital construct. While previous studies mentioned the existence of survivability capital, this study attempts to introduce its various dimensions and test the mobilisation of survivability capital during the COVID-19 crisis.

Research has examined how new ventures strengthen local economic outcomes; however, limited research examines health-oriented ventures and their impact on social outcomes, including health outcomes. Increased VC investment in healthcare service start-ups signals more activity toward this end, and the need for further academic inquiry. We examine the relationship between these start-ups and county-level health outcomes, health factors, and hospital utilization.

Data on start-ups funded via institutional venture capital from PitchBook were merged with US county-level outcomes from the County Health Rankings and Area Health Resources Files for 2010 to 2019. We investigated how the number of VC-funded healthcare service start-ups, as well as a subset defined as innovative, were associated with county-level health measures. We used panel models with two-way fixed effects and Propensity Score Matched (PSM), controlling for demographics and socioeconomic factors.

Each additional VC-funded healthcare service start-up was related to a significant 0.01 percentage point decrease in diabetes prevalence (p < 0.01), a decrease of 1.54 HIV cases per 100,000 population (p < 0.1), a 0.02 percentage point decrease in obesity rates (p < 0.01), and a 0.03 percentage point decrease in binge drinking (p < 0.01). VC-funded healthcare service start-ups were not related to hospital utilization.

This work expands our understanding of how industry-specific start-ups, in this case healthcare start-ups, relate to positive social outcomes. The results underscore the importance of evidence-based evaluation, the need for expanded outcome measures for VC investment, and the possibilities for integration of healthcare services and entrepreneurship ecosystems.