Driving Towards Health Equity in Northeast Ohio

Fri, Feb 3, 2017  -  Comments (1)  -   Posted by Kirstin Craciun

Healthy People 2020 defines health equity as the “attainment of the highest level of health for all people.” Currently, in Northeast Ohio, there are many individuals who are thriving, but there are too many people who are not attaining their highest potential for health. Too often, where a person lives is more indicative of their future health than any other factor.

Here are a few sobering statistics to consider:

• The infant mortality rate, defined as deaths per 1,000 live births, is 5.8 in the U.S. and 22.1 in Cleveland’s Hough neighborhood according to the Ohio Department of Health.
• A recent analysis of Cuyahoga County Board of Health data by The Center found that more than one-third (36.5%) of children under age six in Cleveland’s Glenville neighborhood had confirmed elevated lead levels in 2014 compared to just 1.6% in Cleveland’s Edgewater neighborhood.
• The average life expectancy in Lyndhurst is 82 years compared to 72 years in Glenville – yet these communities are just 10 miles apart as highlighted in a recent report from the Virginia Commonwealth University Center on Society and Health and the Robert Wood Johnson Foundation. 

We have work to do, there’s no doubt. But where we have stark differences in health outcomes among people living in different neighborhoods, often miles apart, we also have the greatest opportunities to address health inequities. I’ll highlight a couple of projects underway that can help move us closer to health equity in Northeast Ohio...

Health Improvement Partnership-Cuyahoga (HIP-Cuyahoga)

Locally, Health Improvement Partnership-Cuyahoga (HIP-Cuyahoga), has drawn sustained attention to the importance of addressing health equity. Led by the Cuyahoga County Board of Health, HIP-Cuyahoga strives to make Cuyahoga County a place where all residents live, work, learn, and play in safe, healthy, sustainable, and prosperous communities.

More than 100 active organizations and 600 people are working together to advance HIP-Cuyahoga’s goals using three key approaches – collective impact, community engagement, and health and equity in all policies. Work is focused around four key issues:

1. Linking clinical and public health
2. Healthy eating and active living
3. Chronic disease management
4. Eliminating structural racism

It’s important to highlight that last bullet point about structural racism – which has been defined as the macro-level systems, social forces, institutions, ideologies, and processes that interact with one another to generate and reinforce inequities among racial and ethnic groups. The truth is that to address health equity means sometimes having conversations that are uncomfortable, as Greg Brown, HIP-Cuyahoga Co-Chair and Executive Director of PolicyBridge, helped us realize during a facilitated conversation at a recent HIP-Cuyahoga Consortium meeting. Health inequities weren’t created overnight and they won’t be undone overnight. But as we work on finding paths that can lead to a more equitable future for everyone in Northeast Ohio, talking about race and the macro-level factors that have created health inequities is vital.

State-Level Population Health Planning

At the state level, population health planning work also holds promise for supporting local efforts to achieve health equity. Led by the Governor’s Office of Health Transformation, the Ohio Department of Health and the Health Policy Institute of Ohio, a diverse array of stakeholders − including many from Northeast Ohio − came together throughout 2016 to inform the development of the State Health Assessment (SHA) and State Health Improvement Plan (SHIP).

If you are looking for comprehensive state data on health and well-being in Ohio, and where we have opportunities to address health inequities, look no further than the SHA. Health equity is a cornerstone of the SHA as evidenced by the mission statement: “Improve the health of Ohioans by implementing a strategic set of evidence-based population health activities at the scale needed to measurably improve population health outcomes and achieve health equity.”

The report contains a wealth of information on how we are faring compared to other states (spoiler alert: not well) on a host of overall measures of health and wellbeing in addition to more targeted information about our state ranking on many specific measures of health such as infant mortality and poor mental health days, to name a few. A key finding of the report is that African-Americans are “much more likely than any other racial or ethnic group to experience poor health outcomes.

And for those of us working at the local level, the SHA spotlights key health measures across regions and counties and where significant disparities exist. Take a look at the data showing infant mortality rates and lead poisoning rates in Northeast Ohio compared to the rest of the state in case you need another reason to address existing health disparities.

Based on the comprehensive set of data in the SHA and engagement with stakeholders, three health priorities were identified in the SHA: chronic disease; maternal and infant health; and mental health and addiction. These absolutely align with the top health needs identified through local hospital and public health assessments for Northeast Ohio and local stakeholders are encouraged to align their community health planning efforts with the work being done at the state-level.

When the SHIP is completed in early 2017, local health departments, hospitals, state agency leaders, community residents and other key stakeholders will be armed with a strategic menu of priorities, objectives and evidence-based strategies that can be used to support local collaborative planning. As stakeholders seek to address the priority topics identified in the SHA, evidence-based practices that have a proven ability to impact health equity will be highlighted. This is important for local leaders to be aware of – if we hold health equity as a crucial goal for our region’s prosperity (#WeWouldBeFoolishNotTo) – we should strongly consider programs with a proven track record of helping to increase health equity.

The Center is committed to and will continue to play an active role in advancing community health and working towards health equity in Northeast Ohio. We will continue to strengthen our partnerships with key stakeholders in the community and across the state who can help us speed up the implementation of evidence-based health programs with a proven ability to impact health equity. There is no reason that a region with as many community and institutional assets as we have in Northeast Ohio can’t make significant progress at addressing health disparities. Join us on this journey towards a more equitable Northeast Ohio – we can do this.