2021 Highlights

Diagram with arrows and links showing elements underlying structural racism
CSII Systems Change for Racial Equity Model

Understanding Racism, Advancing Equity

With community leadership, the CHI Center is approaching the deeply embedded issue of structural racism. Building on the highly collaborative HIP-Cuyahoga community health improvement plan, the Center’s Cross-Sector Innovation Initiative (CSII) used community-based system dynamics to identify systems underlying structural racism and points at which those systems can be changed. In 2021, a core team of cross-sector community partners, guided by Peter Hovmand and Heidi Gullett, continued the work of identifying and mapping those systems and laid the groundwork for identifying intervention points. The project inspired the Cuyahoga County Citizens’ Advisory Council for Equity to use community-based system dynamics for its own exploration of structural racism.

Although CSII came to a close in February 2022, our work on racism and equity from a systems perspective continues. The CSII team is developing practical anti-racism tools and exploring ways in which CSII models can be used to guide programming, policy,  community health improvement planning, and more. 


Building an Integrative Future

An 11-item survey of the respondent's primary care experience
The Person-Centered Primary Care Measure developed by the CHI Center and Larry A. Green Center

As the CHI Center’s name implies, integration – bringing together parts to support a larger whole – is one of our guiding concepts. In 2021, our efforts to strengthen integrative primary care and a generalist approach to health care grew substantially. This work addressed vital aspects of personalized care; measuring what matters in primary care; new technology for practice-based research; and the pandemic’s effects on primary care processes, outcomes, and equity, as well as its very personal impact on patients, clinicians, and practices. As our momentum in this crucial area continues to grow, we will work to inform a new generation in reinventing primary health care and deepening understanding of generalist principles.



Pandemic Leadership and Learning

Woman in white lab coat facing a list of items and speaking
Heidi Gullett

For the past two years, CHI Center Associate Director Heidi Gullett has guided Cuyahoga County’s pandemic response in her roles as County Board of Health Medical Director and Incident Commander during the initial months of the COVID-19 pandemic. Using an equity lens, Dr. Gullett and the Physician Response Team (CHI Center faculty and preventive medicine residents) supported our public health, social services, and healthcare system partners in developing new systems and providing containment and support for the community’s most vulnerable citizens. This collaborative approach -  along with highly accurate computational modeling by the CHI Center's Johnie Rose,  CWRU and Center faculty Daniela Calvetti and Erkki Somersalo, and Alex Hoover, University of Akron - have bolstered the region’s pandemic response and facilitated an effective program of data gathering, contact tracing, and cluster identification.

The Center is also addressing the pandemic through community-focused research. This includes a new NIH-funded study of the pandemic’s effects on community health centers and their patients with multiple chronic conditions (Kurt Stange, Principal Investigator), a new NIH-funded study of COVID-19 and alcohol use disorder (Pam Davis and Rong Xu, Multiple Principle Investigators) and Office of Minority Health research on the delivery of COVID-19-related information to communities hardest hit by the pandemic (Morehouse School of Medicine, Anne Gaglioti Research Core Lead and Co-Investigator).