Cincinnati Children’s Drives the Conversation About Population Health and Health Equity
Post Date: May 2, 2025 | Publish Date:
Population Health and Health Equity
Research Annual Report 2024
From innovative methods to understand how children are affected by toxic exposures to engaging underserved populations in new ways to build healthier communities, experts here go well beyond the campus borders to improve outcomes for all children.
Cincinnati Children’s is dedicated to addressing issues of population health and health equity because we believe that every child deserves the opportunity to reach their full potential. Our commitment is reflected in our comprehensive approach to tackling health disparities, improving access to care and fostering community partnerships. By focusing on these areas, we aim to create a healthier future for all children, regardless of their background or circumstances.
In FY24, researchers here contributed in multiple ways to raise awareness of the importance of addressing long-lingering gaps in the system. Highlights include:
Introducing the 4Ps of Population Health and Health Equity Research
Experts at Cincinnati Children’s are building a new foundation for the science of population health and health equity research. A trio of leaders in the field—Andrew Beck, MD, MPH, Ndidi Unaka, MD, MEd, and Robert Kahn, MD, MPH—laid out core elements of this strategic framework in a viewpoint article published in JAMA Pediatrics.
Their “4Ps Road Map” focuses on Prevention, Protection, Promotion and Partnership to address health disparities in structured, achievable steps. The concept calls for integrating disparity-closing reforms along the entire research pipeline, rather than treating equity as an add-on to traditional scientific work.
“Despite considerable investments in our healthcare system and biomedical research, optimal, equitable health outcomes remain elusive,” the co-authors state. “Moreover, our healthcare system and basic science, clinical and public health research alone are unlikely to achieve the outcomes we seek. We need to build population health and health equity research capabilities.”
How Can Pediatricians Help Reduce Childhood Gun Deaths?
Now the No. 1 cause of childhood mortality, gun violence has emerged as the largest elephant in a room filled with disparities in child health outcomes. Be it deaths related to playing with unsecured weapons, youths using guns in suicide, or children becoming victims of firearm-involved homicides, the pediatric world copes daily with the harms associated with widespread access to firearms in America.
Cincinnati Children’s is working in several ways to address gun violence affecting children, including pioneering the use of virtual reality training to help clinicians talk with families about gun safety and partnering with city and community leaders on a Hospital-based Violence Intervention Program.
Francis “Joe” Real, MD, MEd, was a key guest expert in this widely shared “Intention to Treat” podcast from The New England Journal of Medicine. The podcast reinforces the critical role pediatricians can play.
“Let’s normalize this conversation, make it part of our routine care, and decrease the number of unintentional and intentional injuries related to firearms,” Real says.
Parent-Led Groups Get Real About Managing Childhood Obesity
Sometimes, expert advice gets delivered in ways that families struggle to integrate into their lives. Managing childhood obesity is one such area, where nutrition ideals often clash with the practicalities of living.
In this study, Cincinnati Children’s experts recount how parent-led groups can produce achievable, affordable ideas for food management, exercise and other healthy behaviors when expert-led groups sometimes cannot. Observations were published in April 2023 in the International Journal of Environmental Research and Public Health.
“People with lived experience are the experts of their contexts. Many participants found practical tips useful to share with others,” notes co-author Michelle Gorecki, MD, MPH.
Infants Pay the Price When Parents Battle Food Insecurity and Benefits Red Tape
When parents living in under-resourced conditions also must battle government red tape to stay enrolled in important food benefit programs, the stress measurably affects their babies’ emotional and behavioral health, according to research published in JAMA Pediatrics.
The study, led by Chidiogo Anyigbo, MD, MPH, underscores the importance of stable nutrition for infants during a crucial window of brain development.
“A number of studies have associated household food insecurity with poor pediatric mental health outcomes including depression, externalizing and internalizing behaviors, and hyperactivity,” Anyigbo says. “To our knowledge this is the first study to document the association between household food insecurity and problems accessing nutrition benefits programs and behavioral challenges during the first six months.”
Another key aspect of expanding access to healthy child nutrition involves speaking in the correct language. Anyigbo also co-leads a multilingual awareness campaign for the Women, Infants, and Children (WIC) program in Hamilton County that seeks to improve an online referral system to help more families apply for federal nutrition benefits.
“Unfortunately, in Ohio more than 50% of people who are eligible for WIC do not participate in the program,” Anyigbo says.
Childcare Pick-Up: A 1-Hour Window to Build Healthier Eating Habits
One practical approach to improved nutrition could apply to millions of working parents who routinely bustle their kids to childcare services while they go off to work.
An eyebrow-raising study published in Children’s Health Care revealed that the snacks and drinks many parents provide to children on the way home from childcare centers can be loaded with more calories than people realize. Those backseat moments could become teachable moments.
“Children often look forward to the car ride home, which makes that time an opportunity to start a healthy snacking habit that could last a lifetime,” says co-author Kristen Copeland, MD.
Drilling Into How Social Disparities Contribute to Toxic Exposure Risks
Three scientists at Cincinnati Children’s—Patrick Ryan, PhD, Gurjit K. Khurana Hershey, MD, PhD, and Eneida Mendonça, PhD—were involved in producing a massive multi-center study published in JAMA Network Open that highlights the significant impact of social disparities and early-life exposure to air pollution on asthma risk in children.
The researchers analyzed data from more than 5,000 children born between 1987 and 2007, including a cohort built by the long-running Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS). In one effort to help address ongoing disparities, experts here demonstrated that an asthma risk score tool developed at Cincinnati Children’s performs well across diverse populations. Wider use of the tool could help reach more children who would benefit from earlier interventions.
Carcinogen Found in Third-Hand Smoke Residue
In addition to long-known exacerbations of asthma that can occur when children are exposed to tobacco smoke, research published in the Journal of Exposure Science & Environmental Epidemiology reveals that a potent carcinogen called nicotine-derived nitrosamine ketone (NNK) was found on surfaces in nearly half of the homes tested in the study.
The study was led by first author Ashley Merianos, PhD, University of Cincinnati, and senior author Melinda Mahabee-Gittens, MD, PhD, Division of Emergency Medicine at Cincinnati Children’s.
“Our findings highlight the urgent need to address third-hand smoke as a significant health hazard,” Mahabee-Gittens says.
COVID-19 Has Receded, But Impact Inequities Linger
A study confirming that the COVID-19 pandemic negatively affected kindergarten readiness raises long-term implications for childhood educational outcomes.
The research, published in JAMA Pediatrics, was based on data from about 8,000 kindergartners who took a state-required assessment test. The readiness gap was most pronounced among disadvantaged, Medicaid-covered children.
“Our findings highlight the urgent need for resources and support to help children catch up on lost learning,” says lead author Kristen Copeland, MD, Division of General and Community Pediatrics.
Meanwhile, another study involving several experts here reported that multiple health system hesitancies contributed to the intense impact that the pandemic exerted upon Americans. The analysis was published in Health Affairs Forefront.
“Such hesitancies continue to stand in our way, placing the public at risk for infection, hospitalization, and even death during times of uncertainty and danger. Moreover, disruptive effects of system hesitancies are not shared equally across populations, with disproportionate clinical and economic burdens for the elderly, communities of color, those living with poverty, and children who were forced to see a safe return to school politicized,” the co-authors stated.
Learn about our latest population health and health equity research
Explore the 2024 Research Annual Report
Latest Posts
About this blog
The Research Horizons blog features news and insights about the latest discoveries and innovations developed by the scientists of Cincinnati Children's. This blog does not provide medical advice, diagnosis, or treatment.
Subscribe to Our Newsletter