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How Comprehensive Community-Wide Hypertension Data Inspires Heath Equity

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It’s no secret that the best data often produce the best policies, especially when it comes to community health and wellness. Having accurate, timely and well-informed data is often what makes the difference that enables communities to make dramatic changes in health inequalities.

When it comes to health disparities, Nashville can and should improve. Nashville is nationally known as the capital of healthcare services, but our own community’s health and well-being statistics rank far worse than the cities we compete with every day. increase.

For many people, this comes as a surprise. Nashville has top academic institutions, nationally renowned hospitals, tremendous economic growth, and is home to one of the nation’s largest healthcare and hospital systems. But when compared to cities like Austin, Charlotte, Denver, and Dallas, life expectancy is the worst, and infant mortality, smoking rates, and days of poor mental health are by far the highest.

Figure 1: Overall and comparison According to recent data from the Robert Wood Johnson Foundation, “sister” city Nashville is the absolute worst in measures of life expectancy, infant mortality, smoking, physical inactivity, days of poor mental health and obesity. or ranked close to it. .

How can Nashville, an otherwise thriving city, ensure that all members of its community have the opportunity to lead healthy lives?

First and foremost, Nashville needs to be more intentional in fostering a health culture in which public health infrastructure complements economic prosperity and public health equals economic health. Building this positive culture requires a comprehensive, community-inspired data platform that can pinpoint health challenges, inspire appropriate interventions, and ultimately bridge inequalities and improve health outcomes. is required.


Six years ago I worked with NashvilleHealth. NashvilleHealth is a community-based non-profit organization focused on improving the health and wellness of all Nashvillians, providing a comprehensive, trusted and sustainable source for the collection and analysis of health data that is part of a larger vision. I suggested a possible platform. To move the needle on health disparities in Nashville. Here’s what we said in 2016.

“Currently, there is no centralized data platform for multisectoral health, demographic, and social determinant data for Nashville-Davidson County. It is fundamental to pinpointing barriers to better health, intelligently designing interventions, and measuring and tracking outcomes, saving society healthcare costs (thereby offsetting some of its operational costs), It has the potential to increase our community’s understanding of underserved populations.”

Nashville needed to establish a dynamic, user-friendly, privacy-preserving database that would enable and facilitate significant improvements in community health and well-being. While there is much work to be done to bring this vision to life, Nashville has come a long way since that original proposal.


NashvilleHealth has taken the first step. In 2019, NashvilleHealth worked with the Nashville Metro Public Health Department to conduct a countywide community health and well-being survey to identify and document Nashville’s health challenges. As the first comprehensive health survey conducted in Davidson County in over 18 years, it ranks among the most vulnerable and clearly identified key health challenges essential to achieving sustainable growth and prosperity. revealed serious health inequalities.

Of these, the data for hypertension (hypertension, a preventable cause of morbidity and mortality) were the most alarming.

  • African Americans were most likely to report hypertension (47.6%), nearly twice as likely as Nashville Caucasians, and Hispanic/Latino adults (11.4%), who were least likely to exhibit the condition. was also quite high.
  • Educational level is associated with hypertension prevalence, with college graduates (17.7%) and graduate or professional degrees (23.4%) more likely than those without secondary school education (39.6%). have been reported to have low levels of hypertension.
  • The unemployed were almost twice as likely to report hypertension than those who were employed (23.0% versus 45.3%, respectively).
  • Although not statistically significant, a higher prevalence of hypertension was reported with lower income.
  • North Nashville and Northwest Nashville were historically two underserved communities and two regions with the highest prevalence of hypertension.

This kind of real-time, comprehensive data is necessary to nurture NashvilleHealth’s mission and has the power to catalyze real life-changing impact. Its limitation is that data is collected at a single point in time. To build on these data, NashvilleHealth and I reached out to Belmont University in 2021 to once again propose an inclusive and sustainable data center that positively impacts the health of our communities. .

After meeting with Dr. Sarah Fisher Gardial, Dean of Massey College of Business in Belmont in June 2021, followed in July by Dr. Greg Jones, the university’s then-newly appointed Chancellor, Belmont’s leadership quickly recognized the need. A comprehensive and open data warehouse dedicated to identifying health disparities in our region and driving measurable and repeatable actions.

The university moved quickly to this effort under the guidance of Dr. Charles Apigian, Executive Director of Belmont Data Collaborative. Over the last year, we’ve worked with the American Heart Association, BlueCross BlueShield of Tennessee, Change Healthcare, NTT DATA, Inc, and many others to compile data around the clock, not just for the City of Nashville. Not per se, but Tennessee as a whole. In doing so, they have taken a big step towards achieving our vision of an exposed, interactive data warehouse.

In addition, NashvilleHealth hypertension data (and hypertension data from many other community-minded contributors) were collected, compiled, and analyzed as part of the first report on the state of hypertension in Nashville. In both direct and indirect costs, the report estimates that high blood pressure costs the city of Nashville more than $126 million annually. We also identified major hypertension disparities within Nashville by race, zip code, and health insurance status, and created a map of where to focus attention and resources.

While the report itself is only the first full-fledged product by Belmont Collaborative Data, its findings, along with findings from Nashville Health’s critical early community survey, will help shape sustainable and impactful communities. It effectively set the stage for the entire Hypertension Initiative. A fairer, healthier future. And a healthier community means a fuller life for each of us and generations to follow.

These data reveal disappointing disparities that adequately inform specific interventions to ensure that all Nashvillians have a chance to become healthy. Up-to-date, accurate and robust data not only lead to better policies, but also have measurable and meaningful impact, build bridges between inequalities and downstream health outcomes, and foster a true culture of health and wellness. Strengthen.

The authors acknowledge the visionary support of Caroline Young, Neil de Crescenzo, Molly Sudderth, President Doug Jones, Mark Yancy, and Dr. Charlie Apigian for their many contributions to the creation of the Health and Wellbeing Data Warehouse. I would like to especially thank you. Tennessee.