Connecting Data Across Sectors to Address Cardiovascular Disease

DASH Project Spotlight: Allegheny County Data Sharing Alliance for Health

Visualization of Allegheny County’s Health and Human Services Data Warehouse

Visualization of Allegheny County’s Health and Human Services Data Warehouse

Lead agency: Allegheny County Health Department

Partners/collaborators: Allegheny County Department of Human Services, Allegheny County Economic Development, University of Pittsburgh Medical Center Health Plan, Jewish Healthcare Foundation, Carnegie Melon Traffic21 Institute, University of Pittsburgh Graduate School of Public Health, RAND Corporation

The challenge

In Allegheny County, Pennsylvania, much like the rest of America, one’s neighborhood has a significant impact on their risk of developing cardiovascular disease—the leading cause of death in the county. While many areas of the county are undergoing revitalization, some neighborhoods never recovered after the collapse of the steel industry, resulting in major health inequities across geographies, economic status, and race and gender identities.

For Dr. Karen Hacker, Director of the Allegheny County Health Department, the first step to addressing cardiovascular disease is understanding the root causes of the problem.

“In a perfect world, if there was a way to identify which interventions would have the biggest impact… I can’t even begin to tell you how helpful that would be for all of us. Despite having information on evidence-based practices, we all struggle to take the right approach and to put the right interventions in place where we really think we’re going to see change. It’s very hard to know that in advance.”

The opportunity

When Hacker learned about Data Across Sectors for Health (DASH), she was excited about the opportunity to leverage existing partnerships in order to combine multi-sector data and address questions about the causes and drivers of cardiovascular disease in the county. She explained:

“We’re pulling multiple data sets so that we’re not just looking at more classic health outcomes and health behaviors, but we’re also looking at built environment and other social determinants.”

Through DASH, the Allegheny County Health Department is forming the Allegheny Data Sharing Alliance for Health—a connected data warehouse that combines data from multiple sources to create a more complete picture of the factors impacting the cardiovascular health of the county’s 1.2 million residents.

The collaboration will merge existing disparate data sets from five sectors—public health, human services, economic development, healthcare, and transportation. Once amassed, the data will be exported to a modeling platform, the Framework for Reconstructing Epidemic Dynamics (FRED), to develop a geographically accurate model of the complex distribution of cardiovascular disease risk factors in the county, enabling the community to effectively simulate the potential impact of various interventions.

The county is currently implementing a campaign called “Live Well Allegheny” which focuses on preventing chronic disease risk behaviors, making the DASH project a timely and important endeavor that can help inform which interventions are likely to have the greatest impact on health outcomes.

Engaging sectors to work together

To advance this effort, the health department brings a strong foundation of successful multi-sector collaboration. In the year before they responded to the call for proposals, they formed an Advisory Coalition comprised of over 75 partner organizations from multiple sectors to craft a county-wide improvement plan known as the Plan for a Healthier Allegheny.

The coalition was already committed to an approach that recognized how the social determinants contribute to community health outcomes, so forming an alliance to share data was a natural next step. Hacker described DASH as a “unifying presence” that allows the county to support the infrastructure needed to bring sectors together to achieve the goals outlined in the Plan for a Healthier Allegheny. She noted:

“I’ve always been a believer that a good grant is based on something you’re trying to do already…that you have a foundation of collaboration, and this then becomes an activity or tool to help you move in the direction you’re trying to move.”

Now that the collaboration is in place, the next iteration of the project involves figuring out how to make the data valuable to all of the sectors involved. For example, the health care delivery system is interested in data on co-morbidities, which is critical in helping them determine which patients have care coordination needs. Similarly, the data that is most useful for the economic development sector relates to housing costs, zoning, and land use. Hacker emphasized that incorporating data that builds on the existing goals of various sectors is a key element for ensuring the sustainability of the alliance over the long haul. She explained:

“Some of what we’re learning now is navigating the areas that are going to make people feel like these data sources are not just for this project, but can be used in the future.”

Convening partners around the table in discussions about which datasets are the best indicators for understanding a health condition is critical because these other sectors play a vital role in developing and implementing interventions to address the issue.

Looking to the future

With a wide range of data sources and sectors collaborating, the Allegheny County Data Sharing Alliance for Health provides a foundation for thoughtful joint decision-making, and ultimately, more effective interventions to improve cardiovascular health. Although the alliance represents a fraction of the Advisory Coalition, the larger group of stakeholders is primed to act as recommendations for community interventions are identified.

The project team hopes that the data warehouse infrastructure will be utilized for future examination of a wide variety of pressing health challenges identified in the Plan for a Healthier Allegheny. Hacker commented:

“One of the things about working with a coalition is you can’t stop activity. So things are already moving. We’re already starting a similar strategy to look specifically at opioids.”

There is a growing focus on using big data to address community issues, helping the Allegheny County Health Department continue to bring new partners to the table who are interested in the data they are collecting and housing. The data warehouse will not only help community leaders be more strategic in their public health decision-making, but will also lay the groundwork to bind sectors in Allegheny County together over the long-term.

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