NIH-Funded VNSNY Study Explores How Neighborhood Factors Influence the Health of Local Residents

If chronically ill patients’ neighborhoods provided better access to medical care, transportation, and other essential services, would it improve that population’s overall health? A study currently underway at the VNSNY Center for Home Care Policy & Research is working to answer that very question.

Senior Research Scientist Miriam Ryvicker (shown at left), who has been with VNSNY’s Research Center since 2005, is collaborating on the project with Dr. Barry Silverman, Professor of Systems Engineering at the University of Pennsylvania, who has developed software that simulates real-world scenarios and studies their impact. Funded by a two-year grant from the National Institutes of Health (NIH), Miriam and her colleague are conducting a proof-of-concept study, analyzing previously collected Medicare claims data for older New Yorkers with diabetes, hypertension, and/or heart failure, along with data on various neighborhood factors including income levels, walkability, crime statistics, access to transportation, and availability of primary care and other health care services.

The goal of the study, which will run through April 2019, is to gain a better understanding of how these factors influence health outcomes among a neighborhood’s residents, and determine which types of community interventions are most effective at improving these outcomes. “Using this software, for example, we can take an isolated community like the Rockaways and run simulations to see how residents’ mortality and hospitalization rates would be impacted if we added different combinations of services, such as establishing an urgent care center in the community, or providing transportation to medical appointments,” says Miriam.

As part of the study, VNSNY will also be convening ongoing meetings of an advisory panel of city planning experts, including representatives from New York City’s Department of Health and Mental Hygiene, Department for the Aging, and Department of City Planning, as well as other stakeholders in the healthcare community. This panel will review and validate the Research Center’s findings, with an eye toward developing city planning recommendations that could help remove barriers to care.

“If we find this approach works with our current dataset, our next step will be to apply to the NIH for a larger grant to study more recent Medicare claims data from a broader range of locations and cities,” says Miriam. “We can then use that data to simulate additional types of interventions, and determine whether this approach has value as a decision-support tool for policymakers, insurers, and large providers.” The ultimate aim, she adds, “is to figure out what kinds of community interventions really work and are worth investing in, based on the evidence.”

The Take-Away: The VNSNY Center for Home Care Policy & Research is conducting a study that uses simulation software to evaluate how different community-based interventions would impact the health outcomes of a neighborhood’s residents.