Digital Twin Neighborhoods & the Study of Place and Health

Neighborhoods and health equity are the throughline of everything this lab does — from redlining maps drawn in the 1930s to the digital twins we build today.

NIH/NIA R01 AG080486 PI: Perzynski & Dalton $1.57M Direct Costs 2023–2027
Flagship Project

Digital Twin Neighborhoods for Research on Place-Based Health Inequalities in Mid-Life

Poorer Americans are now expected to live roughly 10 fewer years than wealthier Americans, and cardiovascular disease alone accounts for a huge share of that gap. Traditional risk models built from clinical data alone routinely underestimate risk for people living in disadvantaged neighborhoods — because they leave out the place a person actually lives.

Digital Twin Neighborhoods closes that gap. Working with co-Principal Investigator Jarrod Dalton, PhD (Cleveland Clinic), Dr. Perzynski's team combines de-identified electronic health record data with detailed social determinants of health data to construct privacy-protecting, statistically faithful digital replicas of real neighborhoods. Health systems, community organizations, and policymakers can use these digital twins to simulate what would actually happen to health outcomes — before committing real money or displacing real families — if a neighborhood gained a park, a clinic, cooling infrastructure, or a housing investment.

The project is explicitly community-grounded: its methods were proven through structured community conversations and Community Engagement Studios that let residents shape how their own neighborhoods are modeled and represented.

Selected coverage: Cleveland Clinic Newsroom · Lerner Research Institute · Crain's Cleveland Business · Community conversations paper (PMC)

Related current grants

Restoring Health Equity and Resilience to Cleveland Through Vacant Land Improvements
Office of Minority Health · $2.4M · Site Co-PI

NAVIGATE — Neighborhood Assessment Via Inclusive Gathering and Timely Evaluation
MetroHealth PHERI Pilot · Co-Investigator

Cleveland Healthy Home Data Collaborative
Kresge, RWJF, de Beaumont & W.K. Kellogg Foundations · Site PI, Housing.Health software

Two Decades of Neighborhoods & Health

How the lab got here

Annals of Internal Medicine, 2017

Accuracy of Cardiovascular Risk Prediction Varies by Neighborhood Socioeconomic Position

The foundational finding: patients from disadvantaged neighborhoods had major cardiovascular events at more than twice the rate predicted by standard clinical risk tools — the direct ancestor of Digital Twin Neighborhoods.

JAMA Network Open, 2025

Neighborhood-level inequities in hypertension prevalence and control among mid-life adults

Mapping how neighborhood disadvantage tracks with uncontrolled hypertension across an entire health system's patient population.

Du Bois Review, 2022

Racial Discrimination and Economic Factors in Redlining of Ohio Neighborhoods

A quantitative reckoning with 1930s redlining maps and their measurable, present-day health consequences.

Health Services & Outcomes Research Methodology, 2021

The ADI-3: A revised neighborhood risk index of the social determinants of health over time and place

A methodological backbone for the lab's neighborhood measurement work, built in part on the open-source sociome R package.

American Journal of Community Psychology, 2023

Go-Along Interview Assessment of Community Health Priorities for Neighborhood Renewal

Walking interviews with residents that ground quantitative neighborhood models in lived community priorities.

Innovation in Aging / Oxford University Press, 2025

Digital Twin Neighborhoods for Improving Dementia Care

Extending the digital twin approach to dementia risk and care — one of several biosocial applications of the neighborhood model.

Biosocial Studies

Where biology meets neighborhood and social context

Alongside its population-level neighborhood modeling, the lab runs biosocial studies that connect social and neighborhood exposures directly to biological measurement — genetics, epigenetics, stress physiology, and clinical biomarkers.

Chronic Stress, Epigenetics & Cancer Predisposition

Examining how chronic stress drives epigenetic change and cancer risk in underserved populations (MetroHealth Cancer Institute / PHERI Pilot Award).

Triple Negative Breast Cancer & Neighborhood/Race

Investigating tumor genetics (including WAVE3 expression) alongside race/ethnicity and neighborhood socioeconomic factors (Breast Cancer Research and Treatment, 2023).

Socioeconomic Disparities in Biological Aging

Exploiting residual pediatric blood samples to examine sociomedical risk and resilience — linking early-life social exposure to biological markers of fast and slow aging.

Biosocial Models of Brain Injury & Alzheimer's Disease

A transdisciplinary demonstration project connecting social/neighborhood exposure to brain injury outcomes and Alzheimer's risk (CWRU Provost's Breaking Boundaries Grant, PI Perzynski).