1. Community Health Assessment
MPH 602
Cuyahoga County, OH, Community Health Needs Assessment: spring 2015
Prepared by: Steven Banjoff
Image source nationalatlas.gov

2. The Communities of Cuyahoga County
Map from Cuyahoga County Public Safety and Justice Services.

3. Cuyahoga County
• Location: Northeast quadrant of Ohio
• Population: 1,280,122 Male: 607,362 Female: 672,760 (U.S. Census, 2014)
• County Seat: Cleveland Pop. 396,815 (Cleveland City Planning Commission, 2014)
• Division: 23 Western, 35 Eastern Suburbs

4. Diversity
Cuyahoga County
Race White
African
American
Hispanic
Asian
Native
American
Other
2+ Mixed
Cleveland
Race White
African
American
Hispanic
Asian
Native
American
Other
2+ Mixed
Source: Charts compiled using data from Cleveland City Planning Commission 2014 neighborhood data report

5. Education Attainment Percentage
0
10
20
30
40
Cuyahoga County
Cleveland
Ohio
(U.S. Census, 2014)

6. Economics
0
5
10
15
20
25
30
35
40
45
50
% of
Population in
Poverty
% of Children
in Poverty % of Elderly
65+ in Poverty
Cuyahoga County
Cleveland
Ohio
(U.S. Census, 2014)

7. Median Income
• Cuyahoga County: $43,804
• Cleveland: $27,349
• Ohio: $48,308
(U.S. Census, 2014)
Only one of the 34 neighborhoods that comprise Cleveland has a median
income that is greater than the median income of Ohio and only two greater than
the county median income.
(Cleveland City Planning Commission, 2014)

8. Population Density
Source: (Northern Ohio Data & Information Service, 2012)

9. Cuyahoga County
• More than 2,500 people per square mile (NEOSCC, 2015)
• 8.2% loss of population between 2000-2010 (NEOSCC, 2015)
• 65th out of 88 counties in Health Outcomes (County Health Rankings, 2014)
• 50th in Health Factors (County Health Rankings, 2014)
• 78th in Social Economic Factors (County Health Rankings, 2014)
• 68th in Physical Environment (County Health Rankings, 2014)

10. High Degree of Segregation
Source: (Northern Ohio Data & Information Service, 2012)

11. The Aging of Cuyahoga County
by Gender
% of Total Females in Population
0-4 years
5-17 years
18-24
years
25-34
years
35-44
years
45-54
years
% of Total Males in Population
0-4 years
5-17 years
18-24
years
25-34
years
35-44
years
45-54
yearsSource: Data for charts compiled using Community Commons health indicators report generator

12. The Aging of Cuyahoga County
by Race
Age Distribution: African
American Population
0-4 years
5-17 years
18-24
years
25-34
years
35-44
years
Age Distribution: White
Population
0-4 years
5-17 years
18-24
years
25-34
years
35-44
years
Source: Data for chart compiled using Community Commons health indicators report generator.

13. All Deaths per 100,000
1999-2013
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
< 1
years
1-4
years
5-14
years
15-24
years
25-34
years
35-44
years
45-54
years
55-64
years
65-74
years
75-84
years
85+
Male Black
Male White
Female Black
Female White
Source: Data compiled using CDC Wonder online database National Center for Health Statistics

14. Cardiovascular Disease Related Deaths per 100,000
1999-2013
0
100
200
300
400
500
600
700
800
900
15-24 years 25-34 35-44 45-54 55-64
Male Black2
Male White
Female Black
Female White
Source: Data compiled using CDC Wonder online database National Center for Health Statistics

15. Cancer Related Death per 100,000
1999-2013
0
100
200
300
400
500
600
700
15-24yrs 25-34 35-44 45-54 55-64
Male Black
Male White
Female Black
Female White
Source: Data compiled using CDC Wonder online database National Center for Health Statistics

16. Cerebrovascular Related Death per 100,000
1999-2013
0
20
40
60
80
100
120
<1 Year 1-4 yrs 4-15 yrs 15-24 25-34 35-44 45-54 55-64
Male Black
Male White
Female Black
Female White
Source: Data compiled using CDC Wonder online database National Center for Health Statistics

17. Diabetes Related Death per 100,000
1999-2013
0
20
40
60
80
100
120
140
160
35-44 yrs 45-54 55-64 65-74
Male Black
Male White
Female Black
Female White
Source: Data compiled using CDC Wonder online database National Center for Health Statistics

18. Chronic Lower Respiratory Related Death
1999-2013
0
20
40
60
80
100
120
140
160
35-44yrs 45-54 55-64 65-74
Male Black
Male White
Female Black
Female White
Source: Data compiled using CDC Wonder online database National Center for Health Statistics

19. Accident (non-intentional) Related Death
1999-2013
0
20
40
60
80
100
120
<1 yr 1-4 yrs 5-14yrs 15-24 25-34 35-44 45-54 55-64 65-74 75-84
Male Black
Male White
Female Black
Female White
Source: Data compiled using CDC Wonder online database National Center for Health Statistics

20. Perceived Quality of Health
Cuyahoga County
• 15% of the Population Considers themselves in poor
to average health (County Health Rankings, 2014)
• 3.3 poor physical health days a month (County Health Rankings, 2014)
• 4.1 poor mental health days a month(County Health Rankings, 2014)
• 72nd of 88 counties in quality of life ranking (County Health Rankings, 2014)

21. Obesity
0
5
10
15
20
25
30
35
% of
Population
with BMI >30
in 2012
% of Female
Population
with BMI > 30
% of Males
with BMI > 30
% of
Population
with BMI >30
in 2004
Cuyahoga
County
Ohio
United States
Source: Data for charts compiled using Community Commons health indicators report generator

22. Food Security
Source: Case Western Reserve Mandel School of Applied Science NEO-CANDO system, blue outline = City of Cleveland

23. % of Population Experiencing food insecurity
0
5
10
15
20
25
30
% of Population Food
Insecure
% of Low Income
Population with low
food access
% of Population with
Low Food Access
Cuyahoga
County
Ohio
United
States
Source: Data for chart compiled using Community Commons health indicators report generator.

24. Food Environment
0
10
20
30
40
50
60
70
80
90
100
Fast Food
Establishments
per 100,000
Grocery Stores
per 100,000
SNAP Authorized
food store
retailers
WIC Authorized
per 100,000
Cuyahoga County
Ohio
United States
Source: Data for chart compiled using Community Commons health indicators report generator.

25. Food Behavior
• Percent of Adults 18+ with inadequate fruit and vegetable consumption
76.6%
• Soda Expenditures as a % of Total Household Expenditures
Ranked 82nd of 88 in Ohio
• % of food at home expenditures for Fruits and Vegetables
Ranked 32nd of 88 in Ohio
(Community Commons, 2015)

26. Physical Activity
0
5
10
15
20
25
30
% of Population
20+yrs with no
leisure time
activity
% of Female
Population 20+ yrs
with no leisure
time physical
activity
% of Males 20+ yrs
with no leisure
time activity
Cuyahoga County
Ohio
United States
Source: Data for chart compiled using Community Commons health indicators report generator

27. Access
Source: Obtained from Cleveland Plain Dealer online Northeast Ohio Media Group of map made by Smith Group JJR showing the eastside of Cuyahoga County and the existing park access problem there.

28. Access to Health Care
0
2
4
6
8
10
12
14
16
18
% of
Population
Uninsured
% of
Population
Uninsured
Female
% of
Population
Uninsured
Male
%
Uninsured
African
American
%
Uninsured
White
% of
Population
under 18
Uninsured
Cuyahoga County
Ohio
United States
Source: Data for chart compiled using Community Commons health indicators report generator

30. Health Care Professionals
0
20
40
60
80
100
120
Primary Care
Physicians per
100,000
Dentists per
100,000
Cuyahoga
County
Ohio
United
States
0
5
10
15
20
25
% of Adults
without a
Regular
Physician
% of
Population in
Health
Professional
Shortage
Area
Cuyahoga
County
Ohio
United
States

31. Lead Levels in Children and Median Housing Value
Source: Cuyahoga County Board of Health

32. Cuyahoga County Crime Statistics
Region 1: Cleveland, Lakewood, Rocky River, Bay Village, Westlake, North Olmsted, Olmsted Township, Olmsted Falls, Fairview Park, Brook Park,
Middleburg Heights, Berea, Strongsville.
Region 2: Cleveland, Brecksville, Broadview Heights, Brooklyn, Brooklyn Heights, Cuyahoga Heights, Garfield Heights, Independence,
Maple Heights, Newburgh Heights, North Royalton, Parma, Parma Heights, Seven Hills, Valley View, Walton Hills
Source: Graphs obtained from Cuyahoga County Prosecutor benchmarks and data

33. Cuyahoga County Crime Statistics (cont’d)
Region 3: Cleveland, Bedford, Bedford Heights, Bentleyville, Chagrin Falls, Glenwillow, Highland Hills, Moreland Hills, North Randall, Oakwood,
Orange, Solon, Warrensville Heights, Woodmere.
Region 4: Cleveland, Beachwood, Gates Mills, Highland Heights, Hunting Valley, Mayfield, Mayfield Heights, Pepper Pike, Richmond Heights,
Shaker Heights, South Euclid, University Heights
Source: Graphs obtained from Cuyahoga County Prosecutor benchmarks and data

34. Crime Statistics (cont’d)
Region 5: Cleveland, Bratenahl, Cleveland Heights, East Cleveland, Euclid
Source: graphs obtained from Cuyahoga County Prosecutor benchmarks and data, chart mislabeled as
Region 3

35. Map obtained from Cleveland.com

36. Source: Case Western Reserve Mandel School of Applied Social Science

37. Opportunity
The following health topics have been identified by this Community Health Assessment that are in need of
improvement through intervention, policy change, and raising awareness. The Community Health
Assessment further indicates The City of Cleveland and the inner ring suburbs are areas of greatest critical
need and the health of the county as a whole may be best served by having initial focus on these
communities.
Poverty
Cardiovascular disease
Cerebrovascular disease
Cancer
Diabetes
Respiratory disease
Accidental death/disability
Obesity
Food environment/behavior/security
Physical environment/behavior
Crime
Access to healthcare
Geriatrics
Mental Health
Substance abuse

38. Prioritization
The prioritization process for these health issues should be established by a
predetermined member work group that is comprised of the participating
stakeholders. To make sure the process is as democratic as possible, use of the
National Association of County & City Health Officials guidelines for Nominal
Group Technique should be employed (NACCHO, 2011). This method is particular
useful in the early phases of prioritization that helps to determine group structure,
generate ideas, and allows all to have equal say in the process (NACCHO, 2011).
Step by step guidelines for this process can be found here
http://www.naccho.org/topics/infrastructure/accreditation/upload/Prioritization-
Summaries-and-Examples.pdf to facilitate the proper use of this process.

39. Available Resources
• Cuyahoga County Board of Health
• Cleveland Department of Health
• Cleveland City Planning Commission
• Cuyahoga County Prosecutors Office
• Ohio Department of Health
• Northeast Ohio Sewer District
• Ohio Department of Treasury
• Cleveland Clinic Foundation care network
• University Hospitals care network
• Case Western Reserve Mandel School of
Applied Social Science
• Cleveland State University Maxine Goodman
Levin College of Urban Affairs
• Cleveland State University Howard A. Mims
African American Cultural Center
• Cleveland Restoration Society
• Cuyahoga County Children and Family Services
• The American Heart Association greater
Cleveland chapter
• American Cancer Society greater Cleveland
chapter
• National Alliance for the Mentally Ill, greater
Cleveland chapter
• Cleveland Food Bank
• Northeast Ohio Sustainable Communities
Consortium
• Cuyahoga County Land Reutilization
Corporation
• The Urban Agriculture working group
• The National Organization of Homebuilders
Cuyahoga County chapter
• The Environmental Protection Agency
Cuyahoga County Office
• Cleveland City Mission
• Salvation Army
• Regional Transit Authority
• Cleveland Professional sport teams, Brown’s,
Indians, Cavaliers charity foundations
• Cleveland Metropark System
• Northeast Ohio Areawide Coordination Agency
• Green energy Ohio
• Cleveland Museum of Natural History
• Central Community Food Co-op
• Gund Foundation
• Cleveland Public Art
• Cleveland Industrial Retention Initiative
• State of Ohio
• Center for Disease Control and Prevention
• Various non-profit Religious and other
Charitable Organizations in the area not
mentioned directly

40. Strengths and Weaknesses
• Some of the areas’ greatest strengths are also some of the areas’ greatest weaknesses. The
World class medical facilities help to ensure adequate numbers of primary care officials in the
area and world class treatment, they can also foster a feeling of over-reliance on medical
professionals to manage health issues. The diverse population provides a large pool of far
ranging experiences and cultural information in which to draw, but also sets the stage for
segregation and isolation to occur as each group views differing community members as “the
Other”. The large population supplies better opportunity for revenue streams, larger pool of
people to try and recruit from, and more advocacy groups, but the potential for dissent on
how to prioritize, implement, and fund initiatives and issues is also larger. The multiple
number of advocacy groups provide numerous pathways to greater awareness, collaboration
opportunities, and more programs and initiatives to be implemented, but they also may lead
to information overload and volunteerism burnout or redundancy to occur wasting dollars
that could be better spent elsewhere. The good news is there are strong movements
forward across the area, initiatives like the Heritage Home Program that help homeowners
with home improvement and maintenance for homes over 50 years old, Cleveland Lakefront
Development, Northeast Ohio Sustainable Communities Initiative, Bikeway Master Plan, and
others (Cleveland City Planning Commission, 2015) reveals there is a strong commitment to
improving the environment and health of the community. By further encouraging and
identifying areas of collaboration and community empowerment between Cuyahoga County
and the City of Cleveland, commitment and community awareness will continue to grow, and
its citizens will have greater opportunity to take greater ownership and control of their
health.

41. Works Cited
• Center for Disease Control and Prevention. (2015). CDC WONDER. Retrieved from Center for Disease Control and
Prevention, National Center For Health Statistics, Underlying Cause of Death1999-2013, CDC Wonder online
database, Data from the cause of death files: http://wonder.cdc.gov/
• Cleveland City Planning. (2014). 2014 Neighborhood Fact Sheets. Retrieved from Cleveland City Planning
Commission: http://planning.city.cleveland.oh.us/2010census/factsheets.php
• Cleveland City Planning Commission. (2015). Current Activities. Retrieved from Cleveland City Planning
Commission: http://planning.city.cleveland.oh.us/cpc.html
• Community Commons. (2015). Community Health Needs Assessment Full Health Indicators Report. Retrieved from
Community Commons, date accessed 4/3/15:
http://assessment.communitycommons.org/CHNA/report.aspx?page=1&id=710
• County Health Rankings. (2014). County Health Rankings and Roadmaps, Cuyahoga. Retrieved from County Health
Rankings and Roadmaps, Building a Culture of Health County by County:
http://www.countyhealthrankings.org/app/ohio/2014/rankings/cuyahoga/county/outcomes/overall/additional
• Cuyahoga County Board of Health. (2014). Child and Family Health Services (CFHS) Community Health Indicators
Project. Retrieved from Cuyahoga County Board of Health: http://www.ccbh.net/storage/child-and-family-
health/CFHS%20Indicators%20Report_2014%20Update_FINAL.pdf
• Cuyahoga County Prosecutor. (2014). Regional Crime Statistics. Retrieved from Cuyahoga County Office of the
Prosecutor: http://prosecutor.cuyahogacounty.us/en-US/benchmarks-data.aspx
• Health Improvement Partnership. (2013, March 21). Community Health Status Assessment of Cuyahoga County,
Ohio. Retrieved from Health Improvement Partnership:
http://www.naccho.org/topics/infrastructure/accreditation/upload/full-chachipcombined-3-20-13.pdf

42. Works Cited
Mandel School of Applied Social Science. (2009, September 22). NEO-CANDO updates: Social and Economic Data.
Retrieved from Case Western Reserve University, Mandel School News and Events:
http://blog.case.edu/msass/2009/09/22/neo_cando_updates_social_and_economic_data.html
NACCHO. (2011, October 18). First Things First: Prioritizing Health Problems. Retrieved from National Association of
County and City Health Officials: http://www.naccho.org/topics/infrastructure/accreditation/upload/Prioritization-
Summaries-and-Examples.pdf
NEOSCC. (2015). Population Decline, Northeast Ohio's population is spreading out. Retrieved from Northeast Ohio
sustainable Communities Consortium: Northeast Ohio sustainable Communities Consortium
Northern Ohio Data & Information Service. (2012, August). Maxine Goodman Levin College of Urban Affairs. Retrieved
from Cleveland State University: http://urban.csuohio.edu/nodis/gis_CBMaps.html
Ohio Dept. of Health. (2015). Public Health Assessment and Wellness. Retrieved from Ohio Department of Health:
http://ship.oh.networkofcare.org/ph/indicator.aspx?id=25&c=5
Robert Woods Foundation. (2014, May 12). County Health Rankings and Roadmaps. Retrieved from Robert Woods
Foundation Web site, July 27 2014: http://www.countyhealthrankings.org/app/ohio/2014/overview
U.S. Census Bureau. (2010). American Fact Finder. Retrieved from U.S. Department of Commerce United States Census
Bureau: http://factfinder.census.gov/rest/dnldController/deliver?_ts=445011178441
U.S. Census Bureau. (2014). American Fact Finder. Retrieved from U.S. Department of Commerce United States Census
Bureau: http://factfinder.census.gov/rest/dnldController/deliver?_ts=445011178441