The ACHIEVE GreatER initiative part of multi-institution partnership among Case Western Reserve University, University Hospitals, Wayne State University and Cleveland Metropolitan Housing Authority to address health outcomes
The initiative—Addressing Cardiometabolic Health Inequities by Early PreVEntion in the Great LakEs Region (ACHIEVE GreatER)—involves Case Western Reserve and UH, as well as Wayne State University in Detroit. The entities will work to directly address social determinants of health (SDoH) in Black communities in the Cleveland and Detroit metropolitan areas.
Cutting-edge technology, access to care coordination and guidance on lifestyle, diet and medications traditionally have been the prerogative of the privileged, the researchers said. The ACHIEVE GreatER team will focus on cardiovascular health to study the impact of interventions involving a community health worker-led, personalized, adaptable approach to lifestyle and life circumstances.
The ultimate goal of ACHIEVE GreatER is to reduce cardiovascular complications and hospitalizations by improving blood pressure, lipids and glucose targets for Black patients at risk of heart health issues, said Sanjay Rajagopalan, the principal investigator of the Cleveland Site of ACHIEVE GreatER, along with co-investigators Peter Pronovost and Sadeer Al-Kindi.
Rajagopalan is a professor at Case Western Reserve University School of Medicine, the Herman K. Hellerstein, MD, Chair in Cardiovascular Research, chief of the Division of Cardiovascular Medicine, and chief academic and scientific officer of the UH Harrington Heart & Vascular Institute.
Rajagopalan said socio-economic status, education, geography and environmental factors contribute to the substantial burden of cardiovascular disease in the United States. “There are seismic gaps that exist in health care for Black Americans that continue to result in disproportionate and disappointingly poor outcomes,” he said. “This transformative grant will help to address some of these health disparities.”
The research effort
The Cleveland portion of the research will be done in partnership with the Cuyahoga Metropolitan Housing Authority (CMHA), one of the nation’s largest subsidized housing programs. CMHA will coordinate health events across housing projects in Cleveland to identify patients with disparate health and SDoH needs, said CMHA Chief Executive Officer Jeffrey K. Patterson.
“For so long, health and structural inequities in Black communities have been ignored. ACHIEVE GreatER is a major step toward addressing these persistent health issues in the Black community,” Patterson said. “Through this partnership with CMHA, CWRU and UH, we are committed to strengthening our communities and providing a better future to move us forward. Regardless of where one resides or what is their income level, all people should have the opportunity to receive the necessary medical resources and support to have a healthier life.”
“UH is committed to improving the health of all people in Northeast Ohio by advancing science and human health,” said Mukesh Jain, Distinguished University Professor at CWRU and the chief academic officer at University Hospitals, Harrington Endowed Scientific Director University Hospitals Harrington Discovery Institute, and the Ellery Sedgwick, Jr. Chair and Distinguished Scientist in Cardiovascular Research. “Connecting with Cleveland Metropolitan Housing Authority for this research is a unique opportunity for UH to live out its mission.”
ACHIEVE GreatER will pay for community health workers, nurses and care coordinators to work with CMHA and provide for health services, including free risk factor screening. A nurse-dietician-pharmacist will also join the research, provided by UH’s Center of Integrated and Novel Approaches for Vascular-Metabolic Disease (CINEMA).
Better Health Partnerships (BHP), a Cleveland based non-profit, will partner with UH to offer a community-health-worker model of care to provide sustainability for this effort beyond the grant funding period of five years.
“This is the initial building block around which UH Harrington Heart & Vascular Institute plans to launch a whole range of programs that will address glaring inequities in health care in Northeast Ohio,” said Mehdi Shishehbor, professor at the School of Medicine, president of UH Harrington Heart & Vascular Institute, and the Angela and James Hambrick Master Clinician in Innovation. “As a physician caring for many of these patients in our communities, we have a fundamental duty to provide the highest level of care to each individual and address the disparities in gender, race and ethnicity,” he said.
School of Medicine Dean Stanton Gerson said there could be opportunities in the future to replicate the research in other areas—including on cancer, Alzheimer’s and Parkinson’s disease.
“As a demonstration project focused on environmental stress in social determinants of health, the focus of this award on cardiovascular disease in our disadvantaged populations is essential to improve the wellbeing of our local communities,” Gerson said. “I applaud the lead investigators in pulling together this wonderful team.”
“The relationship between University Hospitals and CWRU is impactful and beneficial in Northeast Ohio and beyond as evidenced by this important work,” said Dan Simon, president of academic and external affairs, chief scientific officer and president of UH Cleveland Medical Center, and the Ernie and Patti Novak Distinguished Chair in Health Care Leadership. “Securing this crucial grant and implementing the ACHIEVE GreatER plan will transform health and ultimately enhance quality of life in this community.”