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Heidi Gullett Working to Help Northeast Ohioans Reach Their Fullest Health Potential

Dr. Heidi Gullett wears a lot of hats. She holds academic credentials in public health and medicine; she is a practicing physician in family and preventive medicine at Neighborhood Family Practice; she teaches at the Case Western Reserve University School of Medicine; she is the medical director for the Cuyahoga County Board of Health; she is the chair of the HealthComp Foundation Board; and she is involved with a number of community organizations. But there is a common thread that ties all of these together. At the core of her work is a commitment to helping ensure her patients, and really all of the many people who reside in Greater Cleveland and beyond, have the opportunity achieve their fullest health potential.

TWEETABLE: This month #TheCenterSpotlights 🔦 Dr. @HGullett, who infuses her work with a commitment to equity and to helping the community reach its fullest health potential.  

In 2013, Gullett helped form Health Improvement Partnership–Cuyahoga (HIP-Cuyahoga), an effort aimed at creating change in order to foster wellness for everyone who lives, works, learns and plays in Cuyahoga County. HIP-Cuyhoga was born out of a community health assessment in 2013 that brought attention to the need to address structural racism in the community. Gullett, along with Greg Brown, executive director of PolicyBridge, became a co-chair of HIP-Cuyahoga in 2014.

“Ever since I was a [medical] resident, I’ve always had a strong interest in poverty and how to address poverty in the context of healthcare and primary care,” she said. “And this was another way to think about it; the issue of racial inequities and concentrated poverty in communities of color.”

HIP-Cuyahoga

Further work following that initial assessment led to the identification of four key priority areas for HIP-Cuyahoga:

• Elimination of structural racism as a social determinant of health.
• Healthy eating and active living.
• Improving chronic disease.
• Improving collaboration between clinical organizations and public health.

Work is underway to address all of these priorities, ranging from improving management of hypertension to bringing fresh food into food deserts to advocating for changes that enable more people to bike in the city of Cleveland.

As part of these priorities, the group sought to create an infrastructure that would allow community health needs assessments to be conducted collaboratively among hospitals, which had recently been required by the Affordable Care Act to begin completing them, and public health, which must conduct these assessments as a requirement of accreditation. The vision is that by bringing together public health and providers, so much more can be done to help people in the community.

“Working individually, none of us will solve poverty, or the obesity epidemic. But if we’re working together, we can begin to work upstream a little bit more,” she said.

Working upstream means not just treating illnesses with medication and surgery but, for example, helping people to have healthy food to eat and a healthy place to live. And it makes sense for hospitals to have a stake in this work. Not only are they responsible for caring for patients who come to them, but through federal policies like those around readmissions and quality measurement they are increasingly responsible for what happens to patients once they’ve been discharged and are out in the community living their lives.

“We’re all in this very rapidly changing health system environment. Payment and delivery reform are happening at the same time and we’re all trying to figure out how to keep up.” she said. “We’re suddenly becoming more responsible for things outside of our health clinic walls.”

Community Health Needs Assessments

Through this work, Gullett came to hold a crucial role as a partner in the community health needs assessment work being done by hospitals through The Center for Health Affairs and co-led by The Center’s Kirstin Craciun, MPP, MSW, director of community outreach. Together, Gullett and Craciun have helped to convene a group of hospitals and public health organizations who are working collaboratively to conduct these needs assessments and develop improvement plans. The first joint hospital-public health assessment involving the Cleveland Department of Public Health, the Cuyahoga County Board of Health, and University Hospitals was completed and released in late 2018. This year, efforts are underway to expand this collaboration to include more hospital and public health organizations.

For Gullett, this work also connects with her other roles, teaching and conducting research at Case. She leads Block 1, which is the very beginning of the medical school curriculum. Here, she has the opportunity to introduce new medical students to important topics related to population health, social determinants of health, and patient-centered care.

“I walk them through this foundation and help them to understand their role in the community and in improving the health of the community,” she said.

Poverty

She also is conducting research focused on addressing poverty with patients. Using the Bridges Out of Poverty program, which provides a framework for thinking about how economic class impacts thinking and interactions with others, she works with patients at Neighborhood Family Practice, helping them to examine their own experience of poverty in order to move from being confined by their present circumstances to being able to think about the future.

“I can never help them be their healthiest self if they don’t have hope for the future,” she said.

Through this research, she seeks to measure how people’s behavior changes, for example through smoking cessation or healthy eating. While she’s still in the midst of the study and has not yet published results, she has witnessed positive outcomes.

“We’ve had patients really transition to creating a hopeful story and that future story has included addressing really powerful determinants of health like relationship stability, seeking jobs, seeking education, and also health-related behaviors like smoking cessation and treatment for addiction,” she said.

Personal Connection

Gullett, who grew up in Youngstown and has a Master’s in Public Health along with her medical degree, has spent virtually all of the last 15 years working at federally qualified health centers. She is also a mom, and emphasizes this work is not just professional, it’s personal too. While the work she does demands much of her, as it does of her colleagues and the many others who are engaged in this mission, she says it’s also important they all remember they, too, are part of this community they are seeking to lift up, and fostering their own health and the health of their families is also important.

“I’m really grateful to have this kind of work and the opportunity to work with so many talented colleagues,” she said. “It’s also really important we don’t forget our own humanity and personal well-being. This work is about what we do for the long term for the community, and we’re part of the community.”

MORE: To learn more about The Center's monthly spotlight on a key stakeholder in the Northeast Ohio healthcare community, contact us.