Health Equity Blog Series: Using Data to Deploy the Right Care in the Right Place

This is the fourth blog in the Dashboard’s Health Equity Blog Series, a regular feature exploring issues impacting health and health equity across America’s cities and diverse communities. We want to acknowledge and thank Dr. Phillip Levy and his team at Wayne Health, who contributed their time and expertise. This blog would not have been possible without their support.

Hypertension, or high blood pressure, is a leading risk factor for heart attack and stroke, two major killers in the United States. In the City Health Dashboard’s over 750 cities, on average, 29.6% of adults reported having high blood pressure. Like many health outcomes, rates of high blood pressure present a health equity issue, with disparities by sex, race, geography, and income. High blood pressure is most common among non-Hispanic Black males living in Central, Southern and Southeastern states. The RESTORE (AddREssing Social Determinants TO pRevent hypertension) Network is a cross-sectoral research program working to reduce rates of high blood pressure by taking these issues of care access and health inequities into account. The RESTORE Network is testing multiple approaches to help communities in five different cities overcome the barriers to health that increase high blood pressure rates, and the City Health Dashboard is proud to be partnering with researchers across the network.

The RESTORE Network project, Linkage, Empowerment, and Access to Prevent Hypertension (LEAP-HTN) at Wayne State University is leading this effort in Detroit. Among all of the Dashboard’s big cities, Detroit, MI has the highest rates of self-reported high blood pressure among adults. Relatedly, the city has the second highest rate of deaths due to cardiovascular disease, and, according to Dr. Phillip Levy, the LEAP-HTN Principle Investigator, when this rate is adjusted for age, heart disease death rates only increase because of the large number of young people dying of heart disease, as compared to average.

Using data from their PHOENIX (Population Health OutcomEs aNd Information EXchange) project, Wayne State’s LEAP-HTN project deploys mobile health units throughout Detroit to provide neighborhoods with high percentages of Black residents blood pressure screenings and personalized health care coaching. Working with community health workers, residents can identify the social drivers of their health challenges and link to existing community resources that can help make a difference. The program focuses on continuous and flexible care, working with residents to improve lifestyle factors with the understanding that some may be inhibited by neighborhood context, such as limited access to healthy foods or lack of safe recreation centers.

The LEAP-HTN project is doing this by turning data into action. The project utilizes PHOENIX data from local electronic health records and data from national surveys available on the City Health Dashboard to get a more complete picture of the community’s health. They look at trends in a population to measure the burden of high blood pressure across the community, rather than on an individual-by-individual basis, to assess overall community needs and where they can best direct their resources.

When local health data are used to bring health resources to those neighborhoods that need them most, they not only advance health but health equity. In Detroit, Wayne State University’s Linkage Empowerment and Access to Prevent Hypertension (LEAP-HTN) project is a case in point.

The map below uses Dashboard data to show which census tracts in Detroit have the highest and lowest rates of hypertension. The neighborhoods with the lowest rates, in light blue, are located in southwest and northeast Detroit. Those neighborhoods with the highest rates are the ones that need the most resources for hypertension screening and control—and where LEAP-HTN has stationed mobile health units that provide blood pressure screening and other services. In all tracts where mobile health units are stationed, more than 43% of adult residents reported high blood pressure. This is more than 13 percentage points higher than the Dashboard city average.

Find out more about what the LEAP-HTN project is doing here and learn about all of the RESTORE network projects here. In addition to Detroit, the four remaining sites are similarly focusing on alleviating common barriers to health.

• Beth Israel Deaconess Medical Center will test the use of a virtual grocery list with weekly healthy food delivery to the homes of Black adults with high blood pressure.

• Johns Hopkins University School of Nursing in Baltimore will provide participants with a home blood pressure machine, connections to a community health worker and a mobile health app.

• NYU Grossman School of Medicine in New York City will engage 30 barbershops to screen Black men for high blood pressure, give them advice about a healthy lifestyle and link them to health care when needed.

• University of Alabama in Birmingham will give members of sixteen churches health education and personal tablets to access online cooking shows and exercise classes, with an experimental health coach by phone.

If you are curious whether approaches like these can benefit your city or community, please see our Take Action resources to explore strategies, potential partners, and funding. You can find racial equity tools, innovative health approaches, and explore how resources may be best distributed in your city.