2018 Cuyahoga County Community Health Assessment

#TransformingHealthTogether

The 2018 Cuyahoga County Community Health Assessment represents an exciting collaboration between Case Western Reserve University School of Medicine, the Cleveland Department of Public Health, the Cuyahoga County Board of Health, the Health Improvement Partnership-Cuyahoga, The Center for Health Affairs, and University Hospitals.

Introduction

The first combined community health assessment in Cuyahoga County

Historically, Cuyahoga County public health and hospital stakeholders completed independent assessments to understand the health needs of the community. In 2018, these organizations committed their time and resources to bridging public health and clinical medicine by conducting a health assessment of Cuyahoga County together. This is the first combined assessment of its kind in Cuyahoga County and represents a new, more effective and collaborative approach to identifying and addressing the health needs of the community. This 2018 work helped prepare this group for an even larger collaborative effort planned for 2019 that will include additional health care systems.

In Cuyahoga County we know that:

  • Cuyahoga County’s mortality rate from cardiovascular disease was significantly higher (199.8 per 100,000) than for the U.S. overall (165.5) and the national benchmark of 100.8.
  • Cuyahoga County’s suicide rate is two points above the national benchmark of 10.2 (per 100,000).
  • County residents report an average of 3.7 poor mental health days per month.
  • The homicide rate within Cuyahoga County (14.2) and the City of Cleveland (28.3) is significantly higher than the national benchmark of 5.5 (per 100,000).
  • Infant mortality rates in Cuyahoga County (8.7 per 100,000) and the City of Cleveland (12.0) are also significantly higher than for the U.S. overall (5.9) and the national benchmark (6.0). Furthermore, the county rate is three times higher for Black, non-Hispanic infants (15.0) compared to White, non-Hispanic infants (4.5).
  • High blood lead levels among young children (age 5 and younger) are a persistent problem. For Cuyahoga County residents under age six, 8.2% had dangerous blood lead levels (> 5 ug/dl) in 2016, and that was significantly higher for young children in the City of Cleveland (12.4%). This compares very unfavorably to the state (2.0%) and national rate (3.0% in 2015) overall.
  • The number of unintentional opioid deaths was high in Ohio overall (32.9 per 100,000), but somewhat higher in Cuyahoga County (38.2). In the City of Cleveland, the rate of unintentional opioid deaths is about twice as high (61.8) as in the county overall. The rate of unintentional opioid deaths in the City of Cleveland is about five times that of the U.S. overall (13.3).
  • Many of the estimated 20,000 or more deaths in the U.S. from influenza each year may have been prevented by the flu vaccine. The national benchmark for vaccination levels among Medicare beneficiaries is 70%. Within Cuyahoga County during the 2017-2018 flu season, only 48.9% received a flu vaccine.
  • Tobacco (cigarette) use in Cuyahoga County is higher than the national rate (21% vs. 15.5%). City of Cleveland residents use cigarettes at a much higher rate (35.2%). Of particular concern is the higher incidence of mothers who smoked during pregnancy (U.S. overall, 7.2%; Cuyahoga County, 9.1%; City of Cleveland, 14.3%).
  • Within the City of Cleveland, residents lack sufficient physical activity at higher rates (58.1%) compared to the national benchmark (32.6%).

Top Health Needs in Cuyahoga County

These top 13 health issues were identified through a careful analysis of the qualitative and quantitative data provided in the 2018 Cuyahoga County Community Health Assessment:

Quality of Life

Poverty

Food insecurity

Chronic Disease

Lead poisoning

Cardiovascular disease

Childhood asthma

Diabetes

Behavioral Health

Flu vaccination rates

Tobacco use/COPD

Lack of physical activity

Mental Health and Addiction

Suicide/mental health

Homicide/violence/safety

Opioids/substance use disorders

Maternal/Child Health

Infant mortality