Cleveland Clinic and The MetroHealth System Receive Grant to Enhance Heart Disease Risk Calculators
$2.2 Million National Institute on Aging Award to Develop New Model Incorporating Environmental and Neighborhood-Level Characteristics
Following its study showing that current clinical prediction models underestimate cardiovascular risk in socioeconomically disadvantaged neighborhoods, a research team led by investigators from Cleveland Clinic and The MetroHealth System has been awarded a $2.2 million National Institute on Aging grant to reduce health disparities for patients at risk for heart disease.
The award supports the development of a comprehensive risk calculator that incorporates an individual’s clinical risk factors in addition to environmental and neighborhood-level characteristics to better predict major cardiovascular disease, such as stroke and heart attack. Current risk assessment tools rely on clinical indicators alone such as weight, age and smoking history, and do not consider factors associated with where patients live.
“Poorer Americans are more likely to suffer from heart attacks and stroke, and are expected to live 10 fewer years than wealthier Americans,” said Jarrod Dalton, Ph.D., of Cleveland Clinic’s Lerner Research Institute and co-primary investigator of the grant. “Accurate risk assessment is critical for identifying high-risk patients so that prevention strategies or targeted therapies can be used. We aim to understand better the complexity of residential, economic and clinical factors, and how they contribute to cardiovascular disease risk.”
The four-year grant is based on the team’s recently published paper in Annals of Internal Medicine analyzing electronic health data of nearly 110,000 Cleveland Clinic patients. The team found that current models severely underestimate risk in socioeconomically disadvantaged neighborhoods.
The study showed that in patients from poorer communities, major cardiovascular events occurred at more than twice the rates predicted by existing risk assessment tools. According to the researchers, socioeconomic inequalities in healthcare are complex and could be related to barriers such as environmental exposure to toxins, financial stress, less healthy eating options and lack of safe places to exercise.
To develop the statistical model, the team will establish a new combined research registry based on electronic health records of more than 200,000 Cleveland Clinic and MetroHealth patients. They will supplement that data with neighborhood-level information from the U.S. Census Bureau and other government organizations. They will overlay this data to build a new comprehensive, systems-based tool for risk prediction.
“Cardiovascular disease remains the leading cause of death for most Americans,” said MetroHealth’s Adam T. Perzynski, Ph.D., co-principal investigator. “Our collaboration on this project will help healthcare providers identify which of their patients could have poor heart disease outcomes. By incorporating non-clinical factors related to where people live, we can enhance personalized approach and target more effective interventions for specific subpopulations, and, ultimately reduce health disparities.”
The research team includes faculty from Case Western Reserve University School of Medicine and the Jack, Joseph and Morton Mandel School of Applied Social Sciences. The NIA grant number is R01AG055480.
The MetroHealth System is redefining health care by going beyond medical treatment to improve the foundations of community health and well-being: affordable housing, a cleaner environment, economic opportunity and access to fresh food, convenient transportation, legal help and other services. The system strives to become as good at preventing disease as it is at treating it.
The system’s more than 600 doctors, 1,700 nurses and 7,800 employees go to work each day with a mission of service, to their patients and to the community. As Cuyahoga County’s safety-net health system, MetroHealth plays an essential role in the region, caring for anyone and everyone, regardless of an ability to pay.
Founded in 1837, MetroHealth operates four hospitals, four emergency departments and more than 20 health centers and 40 additional sites throughout Cuyahoga County. The system serves more than 300,000 patients, two-thirds of whom are uninsured or covered by Medicare or Medicaid.
MetroHealth is home to Cuyahoga County’s most experienced Level I Adult Trauma Center, verified since 1992, and Ohio’s only adult and pediatric trauma and burn center.
As an academic medical center, MetroHealth is committed to research and to teaching and training tomorrow’s caregivers. Each active staff physician holds a faculty appointment at Case Western Reserve University School of Medicine. Its main campus hospital houses the Cleveland Metropolitan School District’s Lincoln-West School of Science & Health, the only high school in America located inside a hospital.
Knowing that good health is about much more than good medical care, MetroHealth has launched the Institute for H.O.P.E.™ (Health, Opportunity, Partnership, Empowerment), which uses a coordinated, collaborative and strategic approach to help patients with non-medical needs such as healthy food, stable housing and job training.
The MetroHealth Glick Center, a new 11-floor hospital, is under construction on the system’s main campus in Cleveland and is scheduled to welcome its first patients in October 2022. The billion-dollar project is the cornerstone of a wider neighborhood revitalization effort led by the system and its partners in the community.
For more information, visit metrohealth.org.