September 28, 2022

Collaboration key to solving health inequities, Cleveland-area hospital CEOs say during Accelerating Health Equity Conference

CLEVELAND, Ohio — Since Metro Health System CEO Dr. Akram Boutros’ 2019 City Club speech in which he blamed structural racism and childhood trauma for many of Cuyahoga County’s public health crises, some organizations that pledged to help are backing away from their commitments, he reported Wednesday.

“I’m seeing backlash, dragging their feet on promises they made and all of those things,” Boutros said. “So, I will tell you that in fact, I’m not getting all these declarations (of support). I am seeing them slipping very quickly in the past six months.”

Boutros, in speaking at the 2022 Accelerating Health Equity Conference in downtown Cleveland, did not name specific organizations, but rather talked in general terms.

Yet even with what Boutros described as a “dragging their feet” by some, he said progress is being made.

He and other area healthcare leaders stressed the importance of collaboration for solving the region’s health disparities.

The conference, which ends Thursday, has drawn speakers and participants from across the country to address how structural racism and economic disadvantages prevent people and communities from enjoying their best health. The conference is sponsored by the American Hospital Association.

University Hospitals CEO Dr. Cliff Megerian, Cleveland Clinic Chief of Staff Dr. Beri Ridgeway and Boutros took part in a panel titled, “Partnering to Invest in Communities: Dialogue with Cleveland Health System Leaders.”

Moderating was Frank Sesno, former CNN anchor and Washington bureau chief, and former director of the George Washington University School of Media and Public Affairs.

Sesno asked the healthcare leaders to describe how they are collaborating to solve community problems such as lead poisoning, infant mortality, maternal health, food deserts and more.

The healthcare leaders pointed to projects such as UH Rainbow Babies and Children’s Ahuja Center for Women & Children located in an area of Cleveland with high infant mortality, MetroHealth’s deal with Cuyahoga County Council to oversee all health care in the county jails, and Clinic’s focus on infant mortality and lead poisoning as examples of ways that health systems are taking medicine to the people.

Healthcare executives are competitive by nature, but in the past three to four years, Cleveland’s major hospitals have begun collaborations to improve community health, Boutros said. It started with the top hospital leaders meeting for dinner, finding common ground and building trust.

“Once there’s trust, unbelievable things happen,” Boutros said.

The Lead Safe Cleveland Coalition, a public-private partnership, is an example of a collaboration among health systems and other agencies.

“We are deciding on how to work together, how to move things forward by rowing in the same direction,” Ridgeway said. “As I’m sure everyone in this audience can attest, there are so many things that we need to solve.”

A hospital can use ground-breaking medicine to treat a patient for heart disease, but if that person returns to a neighborhood where groceries come from a gas station, that patient probably is going to be readmitted, Ridgeway said.

“It’s not a sustainable system if you don’t solve health disparities,” Ridgeway said.

Here are additional highlights from the session:

Future of healthcare tied to communities:

People affected by health disparities fall between the cracks of fee-for-service medicine. “That’s unacceptable,” Megerian said. In the future, hospitals will be responsible for the health of the entire community, not just patients.

“We will be rewarded or penalized for the health of the community; that’s where we’re heading,” Megerian said.

UH has success with women’s hospital

UH Rainbow Babies and Children’s Ahuja Center for Women & Children was constructed in Cleveland’s Hough neighborhood as a way to address the neighborhood’s high infant mortality rate, Megerian said. Mothers in that area tended to skip prenatal care, had poor diets and lacked pediatricians.

Providing prenatal care to the neighborhood contributed to a drop in infant mortality, Megerian said. That success showed how health outcomes can improve when hospitals build easily accessible health centers in communities.

Artist Jo Byrne of Shaker Heights created this visual representation of the panel titled, “Partnering to Invest in Communities: Dialogue with Cleveland Health System Leaders” during the 2022 Accelerating Health Equity Conference. Byrne, who calls herself a graphic recorder, uses markers on foam core to create images reflecting the panel discussion. (Julie E. Washington,

MetroHealth’s building projects meet community needs

For his entire career, Boutros said, he was told to stick to medicine and leave problems like housing and food scarcity to other agencies. He’s convinced that is the wrong approach to healthcare.

That’s why MetroHealth’s $1 billion Campus Transformation project, which aims to address social determinants of health, includes a $60 million redevelopment component, including 250 apartments and community support programs such as fresh food offerings, child care and job training services.

MetroHealth was mindful that its Campus Transformation project could lead to gentrification. Hospital executives asked community leaders how they could prevent that from happening, Boutros said. Based on those conversations, the hospital system pledged to only buy vacant or unoccupied buildings, and to create affordable housing.

Healthy people are good financially

It may seem as if hospitals’ efforts to create healthy communities would be bad for business, but medical services will remain in high demand due to the aging population, Boutros said.

Hospitals don’t suffer financially if they strive to make communities healthier.

Healthy patients come back for ongoing medical services, but “the patient who dies never comes back to you,” Boutros said.