Our research transcends the full spectrum of “populations health” but in considering the health burdens unique to the northeast Ohio region, as well as the strengths and priorities of the Cleveland Clinic enterprise, CPHR maintains a focus on the following broad areas:
Healthcare disparities and access to care
Access to affordable healthcare was selected as one of the most significant health needs in the communities served by Cleveland Clinic main campus, as well as the northeast Ohio region in the Statewide Health Assessment. Access to basic medical care was identified by nearly all interviewees as problematic, and many rely excessively on emergency departments for primary care needs. Lack of transportation options is a significant barrier to good health, especially affecting those with low-income, the elderly, and those with disabilities. Specific issues important to our community include the following:
Between 2012 -2015, infant mortality in Cleveland was double the national average. Upon examination of neighborhoods, pre-term infants born in the Lee-Harvard neighborhood die nearly 8 times the rate as pre-term infants born in the Buckeye-Woodhill neighborhood, just 4 miles away. More than half of the counties in Cleveland Clinic’s 21 county-community had unfavorable rates of infant and neonatal mortality. Contributing factors include poverty, poor housing, smoking rates, lack of time between pregnancies, weigh management issues, and lack of access to and knowledge of prenatal services. Community collaboration is essential.
Healthy eating/Nutrition/Weight Management
36% of residents in Cuyahoga county live in a food desert, and diabetes and obesity were ranked 2nd in the 2016 Community Health Needs Assessment conducted by the organization, for both Cleveland Clinic children’s hospital and Cleveland Clinic Main Campus.
Opioid Epidemic/Chemical Dependency
In 2017, Cuyahoga County saw an average of more than 45 deaths per month attributed to opioids. Already by September 2018, the total number of fatalities attributable to opioid overdoses has surpassed the total in 2017.
Quality and value of processes and interventions
Quality assurance and improvement is a critical part of any health system. As measurements and methods become more accurate, many organizations are striving to understand how best to incorporate social determinants of health indicators (SDOH) to give a more holistic picture of the quality being provided. The National Quality Forum has put together a multidisciplinary team of experts to advise on integrating these SDOH indicators into clinical practice in a way that is actionable and aims to improve healthcare access and outcomes. Within the Cleveland Clinic, we will also be examining interventions and processes focused on improving quality, and working across disciplines to make efforts more inclusive of data that is collected outside the walls of a health clinic.
Methodology for populations health research
Methodology for populations health research is a dynamic area with new insights continuing to emerge. In the past, population-level interventions and policies have been implemented in a blanketed fashion, with recommendations targeted at an entire community, patient population, or disease group. However, new research is showing that risk profiles and models are not evenly applied across various types of populations, and so, recommendations should be appropriately tailored to take that into account. Incorporating risk heterogeneity, intersectionality, and public engagement approaches into populations health research can help to ensure findings are accurate regardless of race, age, or gender, and begin to address issues of health equity.