Continued Partnership with Big Cities Health Coalition

by Rebecca Finkle

When Drexel’s Urban Health Collaborative (UHC) and the Big Cities Health Coalition (BCHC) formed a partnership in 2020, they built it on a shared vision of improving health in the nation’s largest cities through evidence-based public health practice. After three years, this vision has resulted in the creation of an Urban Health Agenda and multiple data platforms that serve public health leaders in 35 of the largest metropolitan jurisdictions, helping them meet the unique and varied needs of their more than 61 million residents. These resources also helped BCHC member cities navigate a deadly pandemic and the cascade of crises that followed, including sharp increases in drug overdose deaths and gun violence.

Reflecting on the past three years, BCHC Executive Director Chrissie Juliano, MPP, notes that “Partnering with the UHC has really extended the capacity of our team, while at the same time has given us access to an expertise on data and urban health research that we wouldn’t necessarily have. The UHC’s work really complements that of our members, pairing research and practice.”

A signature piece of this collaboration is the Big Cities Health Inventory (BCHI), an open-access data platform that is primarily supported by the U.S. Centers for Disease Control and Prevention (CDC), through a cooperative agreement with the National Association of County and City Health Officials (NACCHO) and a partnership with BCHC. The BCHI offers data on more than 100 public health indicators in 35 BCHC member jurisdictions. This year, the platform was updated with new metrics on COVID-19 deaths, homelessness, and flu vaccination. UHC researchers use the Big Cities Health Inventory to examine a range of urgent issues affecting U.S. cities. This work is detailed in a series of briefs that provide both data and social context, revealing structural factors that drive urban health inequities.

The briefs produced this year shed light on some of the country’s most urgent urban health problems. One found that drug overdose deaths had nearly tripled between 2010 and 2020. At the beginning of this period, these death rates were highest among white people; by the end, they were highest among Black people, attributable not only to an increase in fentanyl, but also to racist healthcare practices that create barriers to accessing prescription pain management and addiction treatment. Similarly, gun deaths and obesity rates climbed in many cities, and analysis revealed not only the prevalence of these outcomes, but the web of structural inequities that support and reinforce health disparities – which have only grown starker since COVID-19.

The UHC/BCHC partnership allowed for some of the only documentation of the unique impact of COVID-19 on cities. With support from the Robert Wood Johnson and de Beaumont Foundations, the partnership created the COVID-19 Health Inequities in Cities data dashboard, using a novel framework to measure inequities in COVID19-related outcomes, revealing racial and ethnic disparities in incidence, testing, and treatment. In a paper published in the American Journal of Public Health, UHC researchers documented these inequities in urban Hispanic populations, finding large disparities in incidence, hospitalization, mortality, and vaccination rates, compared to white populations.

In addition to creating innovative data platforms, the partnership also enables urban health department leaders to collaborate in a more low-tech way: They hold a monthly tobacco working group on Zoom, giving members a space to exchange ideas and best practices for addressing tobacco-related policy challenges and innovation.

“The partnership between UHC and BCHC is truly beneficial to both institutions,” says Jennifer Kolker, MPH, Associate Dean for Public Health Practice at Dornsife. “For BCHC, it provides data, planning, and policy expertise to help guide their members in their work. And for UHC, it helps keep us grounded in public health policy and practice and translates our research into action.”