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Every child deserves a chance to thrive. In Northeast Ohio, too many children already have serious health conditions and risk factors that affect all spheres of their lives and will accompany them into adulthood. Better Health's Children’s Health Initiative will focus on high rates of childhood obesity and on improving management of childhood asthma.

Why Children's Health?

The need to address obesity in children is clear. In Cuyahoga County, 51% of poor children aged 12-17 are overweight or obese, according to the Ohio Medicaid Assessment Survey.

Asthma is one of the most common chronic childhood disorders in children.Family history and respiratory infections can play a role in developing or aggravating asthma, but so do exposure to respiratory irritants and allergens, which are common in the city’s poor housing stock. The Centers for Disease Control reports that 49% of children with asthma missed school days because of it.

Getting Started

You can’t manage what you don’t measure, so measuring providers’ performance on nationally recognized and locally vetted standards of care is the first step. Under the co-leadership of Heidi Gullett, MD, MPH, family practitioner and co-chair of HIP-Cuyahoga, and Michelle Medina, MD, Interim Chair, Department of Community & General Pediatrics at Cleveland Clinic, a group of children's health providers has selected standards for overweight and obese children for Better Health’s measurement and public reporting. Health care providers who care for children from across the region are participating. A pilot report is targeted by the end of 2016. Metrics for asthma are next.

How We Improve

Data inform opportunities to improve. Data analyses uncover clinical practices that have excelled -- “positive deviants” – which often identify best practices that can be shared across the community to accelerate improvement. The data also provide insights to population-level health problems for the community to target. The Children’s Health Initiative also will begin to test ways to address non-medical barriers by connecting children and families with health-promoting resources in their neighborhoods.

Our Areas of Focus

Obesity metrics will focus on documented assessment of weight (Body Mass Index) for children ages 2-17 using national standards that account for age and gender; counseling and follow-up as for overweight and obese children; and blood pressure measurement for children aged 3-17.


  • Goals are to reduce rates of childhood obesity and improve management of childhood asthma.
  • Better Health will deploy its proven methods of measurement, public reporting and peer-to-peer learning and dissemination of best practices to drive improvement.
  • The Children’s Health Initiative will test new ways to address non-clinical factors associated with obesity and asthma flares by leveraging clinicians’ influence via referrals to relevant community resources.