In the ongoing effort to improve health outcomes in Cuyahoga County, local partners, including Case Western Reserve University School of Medicine, Cleveland Department of Public Health, Cuyahoga County Board of Health, Health Improvement Partnership-Cuyahoga (HIP-Cuyahoga), The Center for Health Affairs and University Hospitals (UH), have conducted a joint community health assessment. Previously, public health and hospital community health assessments were completed independently in Cuyahoga County. The 2018 Cuyahoga County Community Health Assessment marks a turning point toward a new, more effective, and collaborative approach to identify the health needs of the community.
The 2018 Cuyahoga County Community Health Assessment is a bridge to the next assessment to be completed in 2019. This assessment enables Cleveland Department of Public Health, Cuyahoga County Board of Health, and eight hospitals in the University Hospitals health system to partner and collaborate on a smaller scale prior to conducting a more comprehensive health assessment next year.
“This collaborative community health assessment represents a new way of working together as we highlight a shared vision of improved health for our community,” said Dr. Heidi Gullett, HIP-Cuyahoga co-chair and assistant professor at Case Western Reserve University School of Medicine. “This process brought together both local health departments and University Hospitals to focus on what matters most to our community. The relationships built during this process will enable a comprehensive and inclusive 2019 assessment which will result in new shared priorities on which we will all work together for the next three years. This is a critical step in moving toward equity, creating opportunity for everyone to be healthy, in Cuyahoga County.”
The 2019 health assessment will include the current partners as well as additional Cuyahoga County hospitals and stakeholders that are not required to report until 2019. This will ensure that authentic community engagement is a central part of the planning and improvement process.
“This is a really exciting moment that would not have been possible without many incredibly committed individuals working for years to build trust and create systems change within their organizations,” said Kirstin Craciun, director of community outreach at The Center for Health Affairs. “Hospital and public health stakeholders have demonstrated the ability to find tangible ways of working together, with community, with the goal of creating opportunities for all of our residents to achieve their highest health potential.” Dr. Gullett and Craciun co-chaired the 2018 health assessment steering committee.
While the region boasts first-class health care at its highly rated healthcare institutions, Cuyahoga County ranks in the bottom third in Ohio for health outcomes. Some Cuyahoga County residents are born and live in communities where it is difficult to grow up healthy and maintain good health. Favorable living conditions and opportunities for physical, emotional, and social growth form the foundation for health; without these, people are more likely to live shorter, sicker lives.
Recognizing the opportunity to improve health outcomes through more coordinated, equity-grounded health planning, HIP-Cuyahoga prioritized the need to create stronger connections between public and clinical health in 2015. HIP-Cuyahoga is a cross-sector partnership working to build opportunities for everyone in Cuyahoga County to have a fair chance to be healthy. This approach was chosen based on the belief that it will help reduce barriers and create opportunities for all to reach their fullest health potential in Cuyahoga County.
A critical first step in achieving more aligned community health planning in Cuyahoga County has been the development of a joint community health assessment among public health and hospital stakeholders. Certain hospitals are required to complete a community health needs assessment, commonly referred to as CHNA, and corresponding implementation strategy at least once every three years. This assessment meets federal I.R.S. requirements for the 2018 CHNA for UH Ahuja Medical Center, UH Regional Hospitals (Bedford and Richmond Campuses), The Parma Community General Hospital Association d/b/a UH Parma Medical Center, UH St. John Medical Center, UH Cleveland Medical Center, UH Rainbow Babies & Children’s Hospital, and UH Beachwood Rehabilitation Hospital, LLC. Completing a community health assessment and a corresponding community health improvement plan are also integral parts of the process that local and state health departments must undertake to obtain accreditation. Conducting collaborative assessments has shown to be an effective way to make real improvements in health outcomes in other Ohio counties and areas outside of Cuyahoga County and, most remarkably, in New York State, where they improved their state health ranking to 10th place from 40th in the U.S. over the last two decades.
The Cleveland Department of Public Health, Cuyahoga County Board of Health, and University Hospitals were all required to complete a community health assessment in 2018 and chose to work collaboratively to develop a single, coordinated report. This shift in the way health assessments are conducted by Cuyahoga County’s two local public health stakeholders and one of its largest healthcare systems is a deliberate attempt to work together more effectively and efficiently. Further, it demonstrates the commitment of these partners to gaining a deeper understanding of the significant health inequities that have plagued our county.
Based on the health needs identified in the 2018 Cuyahoga County Community Health Assessment, the following represents the list of prioritized health needs that will be the focus of the one-year equity-grounded implementation plan:
- Poverty (i.e., healthy homes, food insecurity)
- Opioids / substance use disorders / mental and behavioral health
- Infant mortality
- Homicides / violence / safety
- Chronic disease management and prevention (i.e., cancer, diabetes, COPD, asthma, cardiovascular disease, healthy eating / active living)