![Detail of a 1936 Home Owners Loan Corp. "security map," showing Cleveland's East Side neighborhoods near Case Western Reserve University. According to the map legend, green areas were considered "best," blue was "still desirable," yellow was "definitely declining," and red was "hazardous." [Ohio State University Libraries]](https://npr.brightspotcdn.com/dims4/default/e9f6a6f/2147483647/strip/true/crop/980x551+0+0/resize/840x472!/format/webp/quality/90/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2Flegacy%2Fuploads%2F2019%2F10%2F23%2Fredlining.png)
A group of Cuyahoga County health leaders released a report Monday outlining the most pressing community health issues facing the region.
Racism perpetuated by policies and systems, is at the top of their list.
Health and structural racism has been linked in past studies, but Health Improvement Partnership-Cuyahoga aims to have an action plan by early next year.
It’s a daunting goal, HIP-Cuyahoga co-chair Heidi Gullett says, but the group needs to start acting now.
“We asked community to engage with us, we can’t turn around and say, ‘Well in like, five or ten years, we might start actually doing something about this'," she said. “We can’t. We gotta do it now. They’ve been having inequitable opportunity for decades and generations, and it’s about time we have some collective responsibility and address it.”
Structural racism, such as redlining, has a direct correlation to health outcomes in certain communities.
The assessment primarily surveyed African-American and Hispanic Cleveland residents, and for the first time, Spanish questionnaires were available for those who needed them.
It was important for those populations to have a voice, Gullett says, and HIP-Cuyahoga will continue to make sure they have a voice in the action plan.
Reducing poverty and chronic illness are two of the group’s additional goals. HIP-Cuyahoga is also prioritizing mental health and reducing substance abuse, as well as building trust among people and organizations.
When surveying the community, Gullett says they discovered sometimes organizations start working on a solution but stop. Such temporary funding fixes and unstable funding sources ultimately cause trust issues.
“Trust is a huge issue contributing to people not having their full health potential reached,” she said.
This assessment is a follow-up to a smaller survey completed last year. Hospitals routinely do needs assessments as part of their legal mandate and have found similar barriers to health. The HIP-Cuyahoga effort is a wider coalition involving multiple hospital systems in addition to the Cleveland and Cuyahoga County Boards of Health.