UH, Summa & Mercy Hospitals Targeting Racial Barriers To Good Health

The site of the former Harry E. Davis School in Cleveland's Glenville neighborhood will eventually house an affordable housing complex and wellness center as part of University Hospital's efforts to target systemic barriers in health care. [Anna Huntsman / ideastream]
The site of the former Harry E. Davis School in Cleveland's Glenville neighborhood will eventually house an affordable housing complex and wellness center as part of University Hospital's efforts to target systemic barriers in health care. [Anna Huntsman / ideastream]
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Ideastream’s health team is connecting the dots on how racism contributes to poor health outcomes in the Cleveland area. As government and health agencies have declared racism is a public health crisis, officials at University Hospitals in Cleveland, Mercy Health in Lorain and Summa Health in Akron tell us what they have been doing to target structural barriers at the root of health inequities.

In June 2020, several hospital systems across Ohio declared racism a public health crisis.

In Cleveland, University Hospitals supported Cleveland City Council’s resolution to declare the crisis and pledged to do better with its internal and external efforts to reduce racial health disparities.

Bon Secours Mercy Health, which operates hospitals across Ohio including in Lorain and Youngstown, also declared racism a public health crisis.

In Akron, Summa Health released “Summa Stands With Our Community,” a document detailing steps the system would take to educate staff, reduce racial health disparities and promote diversity inside and outside the hospital system.

One year later, some of the hospitals have made progress on internal measures, like requiring employees to undergo racial bias training, but are still working on systemic-level changes.

Graphic of African American silhouettes

Click on this image to find out more about how you can partner with Ideastream Public Media to help connect the dots between racism and health. [melitas / Shutterstock]

University Hospitals

The former Harry E. Davis School on Churchill Avenue in Glenville is covered in graffiti, the grass around it speckled with litter. But the site will eventually be home to a project called Churchill Gateway, an affordable housing complex, wellness center and grocery store, according to its developer, The FRP Group.

And the project has an unlikely partner: University Hospitals (UH), one of the major health systems in Cleveland.

“That’s not traditional health care, right? Organizations aren't getting into the habit of also partnering to build housing, but that's something that we feel is really important,” said Celina Cunanan, a nurse practitioner and midwife at UH.

Glenville is a majority Black neighborhood, with more than 40 percent of residents living below the poverty line. Residents here experience poor health outcomes, such as obesity, according to UH data.

To improve these outcomes, UH officials are expanding past the medical care they provide to focus on patients’ social determinants of health, Cunanan said.

Social determinants are factors that contribute more to a person’s health than the health care they receive, such as where a person lives and whether they have access to healthy food, she said.

 “As health care providers, we traditionally did not look at [determinants]. We provided health care and then sent patients out beyond our four walls,” Cunanan said. “The health care that we give is such a small proportion of what will impact their overall outcome. It's really what happens to them when they leave out there in the world.”

That’s why, she said, UH is embarking on the Churchill Gateway project. They also operate grocery stores called Food For Life markets at UH’s Otis Moss and Portage Medical Center locations to address food insecurity, with another market set to open at UH’s main campus in July, she said.

UH hopes to include a Food For Life Market at Churchill Gateway as well, she added.

To track if these stores are making an impact on patients’ health outcomes, the hospital system is studying markers like hemoglobin, blood pressure and weight of the patients who use the store, Cunanan added.

Within the past year, the hospital system has also changed some of its internal efforts to further address racism as a public health crisis, Cunanan said.

About 1,500 employees in several departments at UH were required to take implicit bias training this year, she said. The hospital system employs 28,000 people across its locations and plans to expand the training system-wide in 2022, officials said.

The training is part of the hospital’s efforts to educate caregivers and make sure patients of minority communities in particular are being treated fairly, Cunanan said.

“We’re doing an internal evaluation to see if it's really changing our employees’ perspectives. Is bias training working?” Cunanan said. “We're also looking at patient satisfaction scores and how are we treating our patients when they come through our doors? That's also a really big one that we always look at to say, ‘what is the experience that patients are having in our in our departments and in our hospitals?’

The hospital system is also looking to increase its spending on women and minority-owned businesses in Cleveland, she said.

“We do buy local, we hire local, but we have to step up programs in which we try and hire local people in our community, job training them, and then hire them into the system,” Cunanan said.

Mercy Health

In Lorain County, another hospital is taking a different approach to addressing disparities in health care: a secondhand store.

The Mercy Thrift Store, operated by Bon Secours Mercy Health. in Lorain, is open to the public and sells donated clothes, toys, and household items. Some patients in need can shop for free.

“If you had no transportation or anything, and you had to walk to your doctor’s appointment and you don’t have shoes, what are you going to do? They’ll write you a voucher and you can come and get shoes,” said Katie Dalton, an employee at the store.

Mercy Thrift Store

Katie Dalton (center), an employee at the Mercy Thrift Shop in Lorain, helps a customer on June 29, 2021. [Anna Huntsman / Ideastream Public Media]

The idea behind the store, said Mercy Health’s director of community health Catherine Woskobnick, is that helping patients satisfy some of these basic needs can improve their access to health care and their overall health. Community health workers in the hospital’s Resource Mothers program, which works with moms who are at risk for infant or maternal mortality, give vouchers to patients who need clothing or other items, she said.

The Resource Mothers program is in part how Lorain County reduced its Black infant mortality rate from 21 deaths per 1,000 live births to 8 over a seven-year period, Woskobnick added.

“[The community health workers] go to the homes. They meet people where they're at. They try to remove the barriers of access to food, access to Wi-Fi for their kids, access to clothes, formula, car seats,” Woskobnick said.

Mercy Health is also trying to make systemic change through an internship program for underrepresented groups in the medical field called Rising Stars, Woskobnick added. More than 80 students have participated in the program since it was created in partnership with the Lorain County Urban League 18 years ago. Five students from the program are currently in medical school and one, Jordan Brown, recently graduated, she said.

“So our goal is that Jordan comes back to Lorain to care for the health needs of the community,” she said.

While Bon Secours Mercy Health is a large system with hospitals across the state, Woskobnick said they are not currently requiring employees to undergo implicit bias training, unlike several Cleveland-area hospitals.

“It was mandated for all leaders and that was in 2019, and then we had COVID happen. And so now the goal is to get back on track for 2021 and 22 for the rest of the associates,” she said.

Hospital staff also host a learning symposium each month focusing on treating patients of different races backgrounds, but it is not required, she added.

“Just recently we have gone over such topics are what are the needs of our African-American patients when they come into our hospital? How are their needs different? How can we ensure that we provide to them?” Woskobnick said.

Unlike UH, no housing projects are planned at this time through Mercy Health, Woskobnick added.

Summa Health

Another hospital system trying to address racism as a public health crisis is Summa Health in Akron.

Last June, the hospital put out “Summa Stands With Our Community,” an action plan to promote diversity, reduce health disparities and educate staff, as well as an evaluation metric to track their progress, said Iriel Hopkins, director of community health and diversity.

To launch the plan, Hopkins hosted a Facebook Live panel titled “A Pandemic Within A Pandemic” about what racism as a public health crisis means and COVID-19 health disparities last June.

“We touched on what that looks like as a health care system as we are addressing the social determinants of health and how we can fill in some of those gaps,” she said. “Education, transportation, food, access, housing, all of those things contribute to the health outcomes of the individual. And so, we can't fully treat an individual clinically without exploring all of these different systemic barriers that affect the health outcome.”

In the first phase of the action plan, Hopkins said, the hospital system overhauled its implicit bias training, which will be required for all employees starting in August.

They also recently created a new hiring policy that will specifically target candidates from underrepresented groups, she said.

Hopkins also spearheaded an evaluation metric to identify these goals and track the hospital system’s progress, she said.

“Those things in our diversity scorecard address our supplier diversity spend, how we’re addressing our African American males that have a high utilization rate in our emergency department and lack of insurance, how are we looking at our hiring practice and who’s getting hired, who’s getting promoted? And then how are we educating our staff,” Hopkins said.

The scorecard is new, so Summa is still collecting this data, she added.

Although there are food pantries available for some patients, the hospital system has not created a grocery store like some of the Cleveland hospitals, she said. However, Hopkins said officials are in talks with a local developer to partner for a housing project down the line.

For phase two of the action plan, Hopkins said officials will begin working with city and county officials to look into bigger, more systemic changes that can be made.

“We know that takes a little bit more research, a little bit more layers to pull back to find out the root causes,” Hopkins said.

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