The 2019 Innovator Awards Semifinalists: Nevada Expands Ambitious Population Health Study

April 2, 2019
In addition to the four winning teams this year, our editorial staff also selected six organizations as runners-up. The stories of these six teams will be published throughout the coming days

Despite leading the country in growth and innovation, project leaders note that Nevada ranks 47th in the nation in terms of health. A collaboration between Reno-based Renown Health and the Desert Research Institute (DRI), the Healthy Nevada Project is a novel population health study to understand and address some of the state’s health most pressing health issues. By examining genetic, clinical, environmental and socioeconomic data, in combination, the goal is to better understand the complex interplay between these factors and related effects on the health of Nevadans.

The pilot phase of the Healthy Nevada Project launched in September 2016, enrolling 10,000 Nevadans in just 48 hours, and within 60 working days, each participant had donated a DNA sample for genotyping. “Some people refer to this as the fastest clinical trial enrollment in the history of the country,” says Anthony Slonim, M.D., president and CEO of nonprofit Renown Health. “We opened it up, not to their doctors who had a hundred other things going on, but directly to people and said all you have to do is show up, and they did.”

The project completed DNA sequencing of nearly 40,000 people in 2018, bringing its total enrollment to 50,000 people, approximately 10 percent of northern Nevada’s population and including a demographically representative set of Renown Health’s patient population.

Researchers are using a SAS analytics-powered platform to analyze population health risks from patient variables such as gender, age, and personal or family health history. The platform is being used to model public health risks ranging from disease and illness to the effects of environmental factors such as air quality. For example, they are working to understand how environmental factors can help predict who may be at risk, allow for quicker diagnoses, and encourage the development of more precise treatments.

“The state has partnered with us so we could get the publicly available data, including from birth and death registries, put them all in one data warehouse and find those trends and patterns to make our community healthier,” Slonim says.

Based on pilot phase data, researchers have seen increased use of regional healthcare correlated with fluctuations in air quality and so-called “bad air events,” such as wildfires and atmospheric inversions. They are evaluating possible links between genetics and increased susceptibility to respiratory ailments.

Slonim, who has lived in Nevada for about five years, says that when he arrived he was appalled by the chronic disease rates in northern Nevada. “We have excessive rates of cancer, of lower lung disease, of heart disease. We’re trying to find out the reasons why at the population health level.”

Slonim is a physician, but he also has a doctorate in public health. “For me this project encapsulates both of those educational experiences.  As a physician, one patient, one family at a time is where my focus is.  As a public health official, the population, the community, and the region are my focus.  Somewhere in the middle is where this project sits, delivering results to both sides of that equation.”

The pilot phase concluded in 2018 and in March of that year, Nevada Gov. Brian Sandoval announced the study’s expansion, opening enrollment to an additional 40,000 participants. Based on the findings of the study’s pilot phase, care providers and scientists have begun working on a number of clinical programs and scientific studies focused specifically on Washoe County’s high age-adjusted death rates for heart disease, cancer, and chronic lower respiratory disease.

The next phase of the project is to expand to southern Nevada in 2019.  Slonim is preparing a TEDx talk at the University of Nevada-Reno in which he plans to discuss expanding the concept to other states in what is calling the Healthy USA project. “I’m currently in talks with five health systems around the country to help us launch this in their states,” he says, “under the guise of the Healthy USA project.”