Three community-academic partnerships have been selected to receive grants of up to $5,000 each from the Detroit Urban Research Center (Detroit URC). These grants will support research that improves the health and quality of life of Detroit residents.

This marks the tenth round of the Small Planning Grant program. We are pleased to acknowledge the support provided this year by the University of Michigan and the Michigan Institute for Clinical & Health Research (MICHR) Communities Engagement Program.  The partnership involving the University of Michigan School of Social Work (U-M SSW) is supported through our partnership with the U-M SSW Detroit Engagement Initiative.

Funded partnerships are:

Addressing a Critical Gap: Perceptions of Young African American Men of their Access to Sexual Health Services in a Community-Based Setting 

In the United States, heterosexual African American males aged 18 to 24 engage in higher rates of risky sexual behavior and have consequently higher rates of Sexual Transmitted Infections (STIs) than other adolescents and young adults. This problem is particularly acute in urban areas like Detroit (Wayne County), which in 2017 had more cases of chlamydia and Neisseria gonorrhoeae than any other city or county in Michigan. There are many barriers for young African American males to seeking sexual and reproductive health (SRH) services and it is unknown which specific factors and tactics motivate this population in seeking SRH services. Identifying key determinants of care seeking and innovative strategies for addressing this gap is essential to improving access to high-quality SRH services in this population.

The focus of this project is to build capacity and infrastructure for a community-academic partnership and to help create community-engaged research that prioritizes areas for sexual health care needs and access to care among adolescent and young adult males in Detroit.

This community-academic partnership between Detroit Community Health Connection (DCHC) and researchers at the University of Michigan School of Nursing is a necessary step to further this area of research. The academic partner (Jade Burns) has 10+ years’ experience working as both a clinician and nurse scientist in urban settings. Detroit Community Health Connection has a rich history within the city of Detroit, celebrating 30 years in 2018. DCHC has a strong presence for providing unparalleled healthcare and service to the community.

Wayne W. Bradley Sr. 
President & CEO
Detroit Community Health Connection (DCHC)

Jade Burns 
Research Fellow 
University of Michigan School of Nursing

Promoting Infant Health and Wellbeing by Engaging Fathers in Home Visitation

The goal of Promoting Infant Health and Wellbeing by Engaging Fathers in Home Visitation is to improve the delivery of services to expectant and new fathers in the State of Michigan, in order to reduce risk factors associated with infant mortality and other negative infant health outcomes. Although early childhood interventions promote maternal and infant health among low-income families, many do not systematically engage fathers in their programming. Research shows that positive father involvement and engagement during pregnancy and infancy are associated with improved wellbeing for infants. A supportive partner has been shown to increase mothers’ adherence to prenatal health guidelines and associated with better maternal physical and mental health. Father engagement efforts that target American Indian communities are sorely lacking.

This project addresses this gap and provides a model through the Engaged Fathers program for how mentors from the community can engage fathers in early childhood programs to provide parent education to low-income fathers.

This project is in partnership with the American Indian Health and Family Services in Detroit who will implement the project amongst American Indian families and other underserved populations in Southeastern Michigan. The agency’s Healthy Start and Early Head Start program will help carry out the project.

Nickole Fox, M.A., C.P.C 
Director of Community Wellness 
American Indian Health & Family Services of Southeastern Michigan, Inc

Shawna J. Lee, PhD
Associate Professor
University of Michigan School of Social Work

Development of the Healthy Chandler Park Community Advisory Board

In 2016, Chandler Park Conservancy, Eastside Community Network, Ascension St. John, and other community partners created and implemented the Chandler Park Healthy Neighborhood Initiative (CPHNI) as part of the BUILD Health Challenge.  The CPHNI addressed cardiovascular disease and Type II diabetes, following 66 of their initial 100 participants for up to 9 months. Health coaches met monthly with with participants in one-on-one sessions, helping them select from various intervention components (e.g. walking groups, nutrition classes, etc.).  The success of the CPHNI is the impetus for continuing and expanding the partnership. The participants wanted to continue their progress, invite other communities, and build off the existing momentum.

This grant will support the partnership formation between Detroit Eastside residents, Chandler Park Conservancy, Wayne State University, Eastside Community Network, and Friends of Parkside in order to establish a Healthy Chandler Park – Community Advisory Board (HCP-CAB). The HCP-CAB will identify health disparities and develop interventions the residents would like to address within their communities while using Chandler Park as the hub for the interventions.  

Wayne State University School of Medicine and Wayne State University Office of Community Engaged Research will assist in developing a strategic framework and sustainability model for the program starting with the HCP-CAB and utilizing Community Based Participatory Research (CBPR) methods. The formation of this partnership will help the HCP-CAB better leverage funding for programs and developments which can be implemented at Chandler Park and advance the health of their community.

Yvette Bass
Program Director
Chandler Park Conservancy

Phillip Levy, MD, MPH
Professor and Associate Chair for Research
Wayne State University School of Medicine

Related Links

Detroit URC Small Planning Grants Program

Winter 2018 Grant Recipients (Round 9)

All Small Planning Grant Recipients

Detroit URC Grant Opportunities

For over 100 years, the Detroit Health Department has been working to promote the health and safety of Detroiters -- all 670,000 of them.  From providing immunizations and screenings to preparing for public health emergencies, promoting the well-being of over half a million people is no small task, but Joneigh Khaldun, MD, MPH, FACEP, the Director and Health Officer of the Detroit Health Department, is up to the challenge.

Tapped by Detroit Mayor Mike Duggan to lead the Public Health Department nearly two years ago, Khaldun has been leading the charge to develop a sustainable public health system in Detroit by addressing the social determinants of health, incorporating neighborhood based solutions, and working with partners who share common goals.

Khaldun recently took a break from her busy schedule to speak with us about how her involvement in the Detroit Urban Research Center (Detroit URC) supports her Detroit Health Department mission.  

How did you first get involved with the Detroit URC?

I first became involved with the Detroit URC when we worked with some of its partners, including University of Michigan (U-M), School of Social Work and Michigan Medicine, on a project funded by U-M Poverty Solutions, connecting community health workers with Detroit residents to improve access to healthcare. I was thrilled to become even more involved as a Board Member when I became Director and Health Officer of the Detroit Health Department in February of 2017.

How has the Detroit URC helped you advance your mission?

One of the values that we have at the health department is partnership.  It is so important in public health to not just launch single programs, but to build collaborations across sectors and with the community, so that we can create healthy environments and communities.  Detroit URC has been a great way to collaborate and share our work.

What do you gain from being on the Detroit URC Board?

I love being able to connect with academic partners, nonprofits, and community members, all with the same focus and mission to improve health.

What initiatives are you currently working on?

In 2018, we completed a robust community health assessment, engaging over 1500 residents and stakeholders about their vision for the community, as well as their identification of community needs and assets. We will be releasing this data in the spring and invite all stakeholders to participate in our Community Health Improvement Planning Process.

In 2018, we also launched iDecide Detroit, an initiative that is youth-led and youth-informed and brings together over 20 medical providers to form a network of care around reproductive health and contraception for people of all ages.

Based on the needs we identified in the community, the Detroit Health Department also opened its own Teen Health Clinic inside the Butzel Family Recreation Center at 7737 Kercheval in Detroit, where we provide reproductive health services and counseling, birth control, and STD testing and treatment.  We provide services regardless of insurance status, and we have evening and weekend hours. For more information, people can call our hotline, 833-9-DECIDE, or visit our website at www.idecidedetroit.com.

We've also been very focused on integrating our services and bringing services into the neighborhood.  In 2018, we launched a neighborhood-based outreach program that provides comprehensive needs assessments for people living in foreclosed homes, connecting them to jobs programs, financial services, and programs addressing health needs.  We also launched an initiative in which outreach workers go door-to-door in neighborhoods where children have historically been found to have elevated lead levels. These staff connect the families in these neighborhoods to education and testing services.  I look forward to continuing this neighborhood based strategy moving forward. It is important that we eliminate barriers to access for residents and meet people where they are.

What do you wish more people knew about the Detroit Health Department?

The Detroit Health Department is open, and we provide a broad scope of services to Detroit residents.  We are also excited to partner with and support other organizations in their work. We cannot address public health challenges alone, and we look forward to expanding our partnerships even more in the future!

Previous Interviews With Board Partners

Suzanne Cleage Director of Neighborhood Growth, Eastside Community Network (ECN)

Lidia Reyes-Flores, Executive Director of Latino Family Services

Guy O. Williams, President and CEO of Detroiters Working for Environmental Justice 

Sheilah Clay, President and CEO of Neighborhood Service Organization

Angela G. Reyes, Detroit Hispanic Development Corporation

In service of their goal of pursuing a healthier, more equitable world through education, research and action, the University of Michigan School of Public Health has recently created a compelling video on the social determinants of health.  It is a nice complement to the work carried out by the Detroit URC and affiliated partnerships aimed at better understanding and addressing the social determinants of health to achieve health equity.

If you have a minute (and 18 seconds), take a look at their new video here.

When deciding on medical care for their children, some parents have to juggle competing concerns, such as whether it is more important to get immunizations early in the season and maybe be a little late to soccer practice or whether it is better to wait a few weeks for immunizations so as not to miss extra-curricular activities. 

For other parents, however, medical care decisions are far more complicated:  is it worthwhile to get immunizations and medical care at all and risk having the family be broken up or is it better to forgo medical care in order to maximize the likelihood that the family is able to stay together?

Parents forgoing medical care for their children is one of the many consequences of the “public charge rule” proposed by the Trump administration, according to recent research from Paul Fleming, Assistant Professor, Department of Health Behavior and Health Education (HBHE), University of Michigan  School of Public Health (U-M SPH), Richard Bryce, Chief Medical Officer, Community Health and Social Services Center, Inc., and their research team.  

Fleming and Bryce received a grant from the Detroit URC and Poverty Solutions to look into the patterns of health and social service utilization among immigrant communities in southeastern Michigan. The research team interviewed dozens of people, from healthcare and social service providers to patient advocates to immigrant patients themselves.

In their recent Detroit Free Press op-ed, Fleming and Bryce describe one of the patients they interviewed.  “Rosa,” a young mother in her 20’s, who was too fearful to have her real name used, has been living in the Detroit area for nearly half of her life.  While cradling her infant at a recent medical appointment, Rosa explained to health care providers that she was considering withdrawing her child from health insurance and from nutritional programs because she fears that keeping her child in these programs would hurt other family member’s chances at citizenship later.

Under the proposed public charge rule, immigrants who use government health care, nutritional programs, or housing programs could be ineligible to receive a visa or United States citizenship.  Although Rosa’s child was born in the US, and is thus a US citizen, fully eligible for all public assistance benefits, Rosa is fearful of utilizing services because not all of her child’s family members are US citizens.  

This situation is exacerbated, according to Fleming, because many immigrants are ineligible for the Affordable Care Act insurance exchanges, so they cannot even buy into insurance in some cases.  Furthermore, many restrictions on immigrants’ work eligibility often force them into low wage jobs, even if they have the educational background to work middle-class jobs that provide insurance.

As Fleming and William Lopez, Clinical Assistant Professor, HBHE, U-M SPH, another researcher on the project, explain in their article for the Conversation, their research indicates that many immigrants -- even those who are here legally and whose tax dollars help fund these programs-- decline using public assistance programs out of fear that it would make it impossible for them and their family members to eventually receive a visa or US citizenship.

In addition to the fear generated by the proposed public charge rule, researchers found an overwhelming climate of fear in many immigrant communities relative to several years ago.  When interviewed, medical staff report that many patients are too fearful to even go to their medical appointments.

Fleming and Lopez describe another such immigrant mother who participated in the interviews.  This respondent was also too fearful to have her real name used, so the researchers gave her the pseudonym “Ximena”.  Ximena, a pregnant mother who fled her native Guatemala to escape violence over 10 years ago, explains that “I have to miss my appointments, because it scares me to leave, because of the fear that one day they’re going to arrest me.  And what would happen to my kids?”

A long-time staff member at the clinic where Ximena cancelled her prenatal appointment points out that many of their clients feel the same way. “They are so much more fearful now than they were two, three, four, five, 10 years ago … huge huge impact, huge difference.”  

This decrease in medical and social service utilization within the immigrant community also has ramifications for the broader community.  

After reviewing the Fleming and Bryce’s research, Kimberlydawn Wisdom, Senior Vice president of Community Health & Equity and Chief Wellness &  Diversity Officer at Henry Ford Health System, sums up the perspective of many health care providers:

“I am very troubled by the consequences for families, and also the unintended consequences that impact the community-at-large. Children and families who are not provided the opportunity to access these type of resources are also not likely to access other important services - like vaccinations - either. The unintended consequences result in suffering for families who contract infectious diseases as well as the general community. If we are truly going to have healthy communities then our practices and policies need to be aligned with that vision.”  

As long as policies and practices make it difficult for some members of the community to decide in favor of vaccinations and healthcare, then mothers like Rosa and Ximena may continue to decide to forgo even basic health care, and the well-being of the entire community will also suffer.