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SDoH Innovation Hub Issues Analysis, Recommends Solutions on Behavioral Health and Gun Violence

The Social Determinants of Health (SDoH) Innovation Hub, formed by The Center for Health Affairs and powered by Amazon Web Services (AWS), with the participation of more than 40 Greater Cleveland community organizations, has completed its first phase of work, providing recommendations for achieving progress on behavioral health and firearm violence.

Data was collected and analyzed from over 50 publicly available sources. Findings revealed that nearly 60% of suicides in Northeast Ohio are from firearms, in contrast with the national average of 50%. Correlations of suicide by firearm with historically redlined neighborhoods, poverty and race were also identified. Lack of transportation and employment are additional factors. Analysis also showed that firearm suicide among youths as young as 12 is rapidly increasing in Northeast Ohio.

Data sources included in this analysis include the Centers for Disease Control and Prevention, Cuyahoga County Medical Examiner’s Office, Federal Bureau of Investigation, and National Gun Archive.

SDoH Hub Recommendations

Based on this analysis and under the advisement of the Behavioral Health and Firearm Violence Work Groups, the SDoH Hub issued its first set of recommendations spanning short-term, defined as three to six months; mid-term, six to 18 months; and long-term, more than 18 months, timeframes.

In the short-term, the SDoH Hub is advocating for the greater coordination of suicide prevention strategies in Northeast Ohio, and to focus on adolescents and young adults facing behavioral health crises. Using the SDoH Hub as the foundation for a multi-sector partnership, the pilot of a collaborative model for prevention is being planned to address the fragmentation of behavioral health services across school and community settings, the juvenile justice system, and mental health service providers.

“The behavioral healthcare system was already experiencing a strain prior to the pandemic, with insufficient resources available to meet the growing demand. What we’re seeing in recent years is a tremendous upsurge in need, including in younger populations, where intervention and support can truly change the course of their lives for the better,” said Daniel Lettenberger-Klein, chief executive officer at Stella Maris and co-chair of the SDoH Hub Behavioral Health Work Group.

Over the mid- term, the SDoH Hub recommends increased access to behavioral health services, especially in school settings, and for rural populations and historically underserved communities, along with efforts to increase the diversity of the behavioral health workforce. Long-term recommendations include enacting policies to improve economic mobility, encompassing basic income, childcare, climate change, digital access, education, food, green space, housing, jobs, tax credits and transportation, as well as policies that support and stimulate the economy of Northeast Ohio.

“Autonomy and self-determination are crucial. When these are lacking, we see fragility, despair, and violence. These SDoH strategies get to the root, by both helping people get the care they need in the short term, and calling for systemic interventions over the longer term to enable people to feel empowered,” said Edward Barksdale, MD, Robert J. Izant, Jr. MD Professor and surgeon-in-chief at Rainbow Babies and Children’s Hospital/University Hospitals and Case Western Reserve School of Medicine as well as co-chair of the SDoH Hub Firearm Violence Work Group.

The Behavioral Health and Firearm Violence Work Groups will complete the plan to launch the pilot prevention programs focused on specific Cleveland zip codes between now and April 2024. In addition, the SDoH Advisory Council will launch the Economic Mobility Work Group under which work groups will be created and tasked with addressing the factors described above from basic income to transportation.

“The Center for Health Affairs is pleased to have reached this landmark, with the release of the first set of recommendations based on the work of the SDoH Hub,” said Brian Lane, president & CEO of The Center for Health Affairs. “This is the culmination of significant collaborative efforts among the participating partner organizations and under the leadership of our Work Group Chairs. But the work doesn’t stop here. We will continue to push forward with the implementation of these recommendations as well as explore others other areas of SDoH to make a meaningful impact for our community.”

About the SDoH Innovation Hub

The SDoH Hub was formed in July 2022, when The Center for Health Affairs and Amazon Web Services (AWS) initiated a three-year agreement to address the root cause of health disparities – structural racism – through solutions based on social determinants of health, including housing, climate change, education, food, employment, transportation and – the focus of this first phase of work – behavioral health and violence.

The SDoH Hub operates under the guidance of community residents, nonprofits and the public and private sectors to identify and implement solutions through research, analytics and measurable outcomes. Led by the SDoH Advisory Council, the Hub will leverage data-driven insights to help inform and identify programs and policies to improve the health of individuals and populations.

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