by Jarrod Dalton, PhD, Director, Center for Populations Research, Cleveland Clinic Lerner Research Institute
This article is a Health Disparities Researcher Self Portrait authored by a CTSC-supported health disparities researcher.
I’m Jarrod Dalton, PhD, and I design new approaches to examining the systems fueling health inequity. My experience is shaped through decade-long relationships with other Cleveland institutions tackling the same, complex problems.
I carry that collaborative approach into my new position directing the Center for Populations Research at Cleveland Clinic’s Lerner Research Institute. My research uses quantitative methods to shed light on the role that societal problems – including systemic racism, racial segregation and disinvestment in communities – has had in producing health disparities and inform strategies for addressing them.
Understanding how deeply these divides run has been a lifelong journey. Though almost everyone in the region where I grew up in rural Ohio and Pennsylvania was of limited means, working in healthcare in Cleveland shed light on how severely city neighborhoods are affected by economic disinvestment and other societal factors.
I have gained an understanding of the wrongness that has been done to racial and ethnic minorities over the last 90 years, the ensuing residential segregation, and the ultimate disinvestment in urban communities – and I'm still learning.
My research career began in 2006 at the Cleveland Clinic as a collaborative biostatistician, offering analytic consulting support for clinical research studies. I earned a PhD in 2013 from Case Western Reserve University in epidemiology and biostatistics.
I have current long-standing collaborations that started during my time training as a Clinical and Translational Science Collaborative of Cleveland (CTSC) KL2 Scholar. The CTSC connects physicians, nurses and other medical professionals with researchers and engineers to encourage an interdisciplinary approach to translating basic research to patient care.
Connecting experts from across sectors, including local government officials and neighborhood groups, is a key part of my approach to addressing healthcare disparities through population health research and new, cutting-edge technologies. It’s also a key mission for the Center for Populations Research.
My team first focused on the disparities in Cleveland’s neighborhoods that lead to a disproportionate risk of a cardiovascular event, like a heart attack or stroke. After incorporating place-based factors into prediction models, researchers found guideline-recommended practice of estimating someone's risk of major cardiovascular events based only on clinical factors tends to be biased.
Risk was as high as double that being predicted based on clinical risk factors alone. Not taking these socioeconomic factors into account may result in undertreatment of cardiovascular disease for individuals from low-resource neighborhoods.
Collaborations, like ongoing projects with MetroHealth’s Adam Perzynski, PhD, Case Western Reserve University Center for Health Care Research and Policy, are using electronic health records from multiple sources to better fuel this research. Outside of cardiovascular events, research teams are also using data for a more comprehensive approach to documenting and analyzing dementia and life expectancy.
Though collaboration is important, researchers working on health equity research need to understand themselves and their motivations as well. Writing a career mission statement incorporating values and future goals is helpful when making important decisions. After that, learning from as many people as possible and incorporating their viewpoint can then help better understand the problems that affect specific populations. Then, connect with experts from a variety of disciplines, understand their perspectives, and don't try to go at it alone.
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Jarrod was a KL2 Scholar through the Clinical and Translational Science Collaborative of Cleveland.