What Does Internet Access Have To Do with Health?

The Urban Health Initiative continues efforts to raise awareness of internet access and digital skills (collectively called “digital inclusion” as a fundamental social determinant of health.  Internet access, either via fixed broadband or through mobile access, has a direct impact insofar as it enables patients to communicate with their providers, track and report symptoms, view their laboratory test results and order medication refills, for example.  Smartphone-based apps can support healthy behaviors such as smoking cessation, tracking nutritional intake, encouraging physical activity and providing medication reminders.  Indirectly, internet access and skills are virtually essential for education, applying for jobs or loans, and even obtaining government benefits.  And crucial for the CTSC, internet access is increasingly essential for participation in clinical research.

Adam Perzynski and colleagues recently published an important paper documenting disparities in the uptake of MyChart, the patient portal to the Electronic Health Record at MetroHealth.  Overall uptake was lower for blacks (23.4%) and Hispanics (23.8%) versus whites (34.1%) and for patients with no or public insurance (17.4% - 26.5%) versus commercial insurance (39.3%).  But especially interesting is that patients living in neighborhoods better served with high-speed internet were considerably more likely to use MyChart than those living in less well-served neighborhoods. 

This disparity is not simply a matter of the affordability or preferences in using the internet.

Thanks to efforts of partners at community organizations we work closely with, national attention was recently drawn to an analysis that showed that one of our main local internet service providers “has systematically discriminated against lower-income Cleveland neighborhoods in its deployment of home internet and video technologies over the past decade…Because the patterns revealed by this analysis result from a decade of deliberate infrastructure investment decisions, NDIA and CYC believe they constitute strong evidence of a policy and practice of “digital redlining” by AT&T — i.e. income-based discrimination against residents of lower-income urban neighborhoods in the types of broadband service AT&T offers, and in the company’s investment in improved service.” 

Other communities are now clamoring to replicate the analysis done in Cleveland.  The first results completed show similar patterns in Dayton, Ohio.  The University of California, Berkeley just published an analysis showing statewide that the median income of household with access to AT&T’s gigabit fiber network is $32,297 higher than in areas lacking this access.  Laws regulating broadband deployment differ by state, but the deployment pattern in Ohio may violate state laws against provision of telecommunication services on the basis of race or income.   In response, a high profile attorney has issued notice of his intention to file a lawsuit on behalf of Cleveland residents who claimed to have been harmed by their lack of internet access. 

Local action to address digital inclusion

As part of its recognition of Digital Inclusion Week, Cleveland City Council is planning a hearing on Wednesday, May 10th.  The organizers have asked the Urban Health Initiative to  prepare and provide Health Data MattersLiveStories maps showing how internet access disparities compound the effects of racial segregation and poverty. 

These and other issues were explored  on Health Data Matters during the first meeting, in April, of a Public Health Data Sector workgroup meeting convened by DigitalC, and during a 2-hour workshop, also hosted by DigitalC in April, helping community and government organizations to use Health Data Matters’  LiveStories platform. 

Bringing Community Health Perspectives to Medical Innovation

Urban Health Initiative Executive Director Amy Sheon served on the planning committee for the first Cleveland Medical Capital Innovation Competition.  The April 25-26th competition included 22 professional and 5 collegiate teams selected from 180 applicants.  Amy was one of several mentors who helped teams shape the pitch they would give to judges on Day 2.  Her particular focus was on the importance of incorporating perspectives of underserved populations and of considering the population health impact of their technologies. 

A Case Western Reserve University team was among the top winners in the competition.

The Department of Medicine Research Day will be held on Friday, May 12, 2017 at the Wolstein Research Building.  Information regarding registration can be found at http://www.cwrumedicine.org/research-day .

For more information please contact Martha Salata at 844-1988 or mks18@case.edu.

•          Social/behavioral research
•          Biomedical research
•          Innovative research
•          Regulatory landscape
•          Community engagement

The Bill & Melinda Gates Foundation is inviting proposals for the latest round of Grand Challenges Explorations. Grand Challenges Explorations fosters early-stage discovery research to expand the pipeline of ideas for solving our greatest global health and development challenges. Launched in 2008 with an initial $100 million commitment from the foundation, Grand Challenges Explorations grants have already been awarded to more than 1200 researchers in more than 65 countries.

Applicants can be at any experience level; in any discipline; and from any organization, including colleges and universities, government laboratories, research institutions, non-profit organizations, and for-profit companies. Initial grants will be US $100,000 each, and projects showing promise will have the opportunity to receive additional funding of up to US $1 million. 

Applications will be accepted on the following four topics:

• Health Systems Strengthening: Ensuring Effective Health Supply Chains;
• New Approaches for Improving Timeliness of Routine Immunizations in Low-Resource Settings;
• Wearables and Technology for Maternal, Neonatal and Child Health Behavior Change;
• Innovations for Integrated Diagnostics Systems;

Application Deadline: May 3, 2017

For more information visit the Grand Challenges website.

The Howard Hughes Medical Institute (HHMI) has announced that it seeks to appoint up to 20 new biomedical researchers through a national open competition. HHMI recently increased the standard term for HHMI investigators from five to seven years, providing longer term, flexible support as these scientists explore new research territory. The initiative represents an investment of approximately $168 million in basic biomedical research over the next seven years.

The HHMI investigator competition is open to basic researchers and physician scientists at more than 200 eligible institutions who bring innovative approaches to the study of biological problems in biomedical disciplines, plant biology, evolutionary biology, biophysics, chemical biology, biomedical engineering, and computational biology. Those selected in this competition will receive a seven-year appointment to HHMI, which is renewable pending favorable scientific review.

HHMI encourages its investigators to push their research fields into new areas of inquiry. By employing scientists as HHMI investigators—rather than awarding them research grants—the Institute is guided by the principle of “people, not projects.” HHMI investigators have the freedom to explore and, if necessary, to change direction in their research. Moreover, they have support to follow their ideas through to fruition—even if that process takes many years.

Application Deadline: June 27, 2017

For more information visit the HHMI website.

The Methods Validation Grants will focus on validating pre-existing methods including algorithms and analytic tools used to maximize the use of data in predicting outcomes. 

The purpose of the Methods Validation Grants is to identify methods to improve the integration and analysis of data within and across large and diverse datasets using cloud computing. A successful grant will include information on how the previous method or tool was used, the evaluation and validation of the proposed method, and the plan for utilizing the AHA Precision Medicine Platform http://precision.heart.org to serve the greater scientific community. 

The award seeks to test and validate:

• new machine learning algorithms to curate and harmonize data in the cloud;
• new natural language processing methods for electronic health records in the cloud;
• new pipelines to enable more effective and efficient workflows for analyzing data in the cloud;
• New pipelines for data curation in the cloud

These grants are open to all scientists. Knowledge of biology and/or computer science may be helpful. Collaboration with other scientists (in any field) is optional. Applicants are to provide proposals that adhere to the above broad objectives while specifically addressing the outlined goals. Faculty/ staff members conducting independent research at time of application. At application, principal investigator must hold an M.D., Ph.D., D.O. or equivalent terminal doctoral degree and must meet institutional requirements for grant submission. There are no field of study restrictions so long as the applicant demonstrates ability to complete the project proposal with the allotted time and money made available by the grant. Awardee must meet American Heart Association citizenship criteria and research status if at a foreign university throughout the duration of the award. Applicants are not required to reside in the U.S. for any period of time before applying for American Heart Association funding. 

Application Deadline: June 29, 2017

For more information visit the AHA website.

Limited Competition for NIH-Industry Program: Discovering New Therapeutic Uses for Existing Molecules (UG3/UH3)