Generating Actionable Insights on SDoH Using AWS with The Center for Health Affairs

Established in 1916, The Center serves as a regional association for hospitals and healthcare organizations supporting communities in Northeast Ohio.

According to a study published in the American Journal of Preventive Medicine, a variety of factors impact patient health, with a mere 16 percent of outcomes being determined by clinical care. In other words, socioeconomic factors, health behaviors, and physical environments have a larger combined effect on patient health than medical treatment. AWS and The Center started working together in July 2022 as part of the Impact Computing organization from AWS to bring advanced computing solutions to solve for health equity–related challenges around the world. By December 2023, The Center built the SDoH Hub with support from IPC Global.

The Center previously analyzed the impact of SDoH using Healthy Northeast Ohio, its repository of population health data from publicly available sources. The SDoH Hub built on The Center’s prior work by offering actionable data to inform policy recommendations. “Because we can use the full stack of the AWS Cloud in conjunction with data that’s available, we can do much more and be people-oriented, making someone’s life better rather than just giving them data to read,” says Endrit Meta, data and technology director for The Center. Using Amazon SageMaker—which provides the fully managed infrastructure, tools, and workflows for building, training, and deploying machine learning models for any use case—The Center can access insights quickly and focus on next steps.

The Center’s SDoH Hub involves over 200 organizations, pulling data from various sources, including publicly available data, to facilitate meaningful, data-driven insights. Over its first 18 months, the SDoH Hub accessed over 15 million records, securely processing both structured and unstructured data. The Center stores data using Amazon Simple Storage Service (Amazon S3), an object storage service offering industry-leading scalability, data availability, security, and performance. The Center uploads data once and then monitors the system for modifications. To perform data analytics, The Center uses Amazon Redshift, which helps power data-driven decisions using the best price-performance cloud data warehouse. “We can be very agile using AWS,” says Meta. “We built something scalable that supports our different workloads and changing needs. We can scale up and down as needed.”

Along with The Center, there are over 15,000 nonprofits working in Northeast Ohio. Each one has its own mission and methods for addressing a portion of the challenges facing the community. To break down silos, The Center aims to equip its peers with data-informed strategies to address root causes rather than treating symptoms. Using AWS, The Center will also collect and ingest confidential, individual-level data from partner organizations in a secure manner, complying with HIPAA regulations. With the SDoH Hub, organizations retain control of their data, receive targeted intervention recommendations, and can work with the community to take action. “With input, guidance, and direction from the community to identify priorities, we built the SDoH Hub on AWS as a collaborative and integrated effort to solve protracted local problems,” says Dr. Kim Byas, SDoH leader for The Center.

The Center is focusing on Cleveland for its initial project but has plans to create a template that can be applied globally. From the SDoH Hub’s initial data analysis, The Center identified the three zip codes in Cleveland with the highest rates of firearm-related suicide and determined the suicides were correlated with housing insecurity, lack of transportation, and unemployment. The Center plans to analyze data about the individuals living in those zip codes and collaborate with partner organizations to develop policies and programs that can improve access to housing, transportation, and employment. The SDoH Hub will then help assess the impact of these SDoH interventions on future rates of firearm-related suicide in the impacted communities.