Since 2000, the Healthy Environment Partnership (HEP) has used a community-based participatory research (CBPR) approach to promote heart health and health equity in Detroit. HEP is an affiliated partnership of the Detroit URC that studies and conducts interventions to better understand and address social determinants of racial and socioeconomic health inequities, with a particular focus on cardiovascular disease (CVD).

A complex set of social determinants of health influence health inequities. HEP has examined risk factors including stressful social and economic conditions in Detroit neighborhoods, neighborhood walkability, access to healthy foods, and air pollution – all of which affect the health of Detroit residents. HEP has also examined protective factors (e.g., social relationships, participation in walking groups) and their role in reducing disease risk and negative health outcomes.

“Discrimination sets back our communities in most areas important to living healthy thriving lives,” says Angie Reyes, Executive Director of the Detroit Hispanic Development Corporation and a founding partner in HEP. “Having lead a non-profit organization in Detroit for 21 years, I have witnessed the detrimental effects it has had in our community.”

Recently, a team from HEP published research in Ethnicity and Health that demonstrates links between heightened self-reported institutional discrimination and increased blood pressure for Black and Latina/o adults. This paper builds upon accounts from residents, HEP, and multiple social movements that have documented increases in institutional and interpersonal discrimination towards communities of color.

Using data from a subset of the same Detroit residents over a six-year period in the early 2000s, the researchers measured institutional discrimination, including lifetime experiences of unfair treatment in work, education, by the police or immigration officials, housing, obtaining resources/money, or healthcare – measures that are part of the Acute Unfair Treatment Index, developed by David R. Williams and colleagues and first tested in the Detroit Area Study about 20 years ago. Blood pressure readings were collected three times during the course of interviews with participants. For this study, discrimination and blood pressure patterns were tracked over time by race and nativity.

The researchers found significant racial differences in discrimination patterns from 2002 to 2008, with non-Latino Black and Latina/o adults reporting greater increases in discrimination compared with non-Latino White adults. They also found that heightened institutional discrimination was more strongly associated with increases in blood pressure among non-Latino Black adults relative to non-Latino White adults and among Latina/o immigrants relative to US-born Latina/o adults.

“We know that discrimination makes us sick,” said Dr. Alana LeBron, lead author of the study. “These findings link increases in residents’ reports of discrimination with a sociopolitical context that has become more restrictive towards communities of color – increases in restrictive immigration policies, policing of communities of color, and an economic recession that disparately affected racial minority communities. We find that these increases in reports of institutional discrimination are linked with declines in cardiovascular health over a relatively short period of time: 6 years.”

Angie Reyes, a co-author of the paper, noted “Families worry about finances, access to equitable housing opportunities, having quality educational options for children and are being harassed by immigration officials; discriminatory practices just intensify the socioeconomic struggles our families are facing. These findings help shed light to those detrimental effects on people’s health and help change the narrative of being an individual issue to a systemic one.”

View information about the paper online.

HEP Partner Organizations

• Chandler Park Conservancy
• Detroit Health Department
• Detroit Hispanic Development Corporation
• Eastside Community Network
• Friends of Parkside
• Henry Ford Health System
• Institute for Population Health
• University of Michigan School of Public Health
  Community Members At-Large

Neighborhood Service Organization (NSO) provides services that have impacted countless children, youth, adults, seniors, families, and communities since 1955. As a member of the Detroit URC’s Board, NSO contributes to the development of new community-based participatory research projects, capacity building and related activities.

President and CEO Sheilah Clay recently spoke with us about NSO’s work and involvement in Community-Based Participatory Research (CBPR).

The mission of NSO is “Changing lives through innovative human services that harness the power of choice.” What does it mean to harness the power of choice?

It means that we’re driven by the decisions and the desires of the people we serve. When I do new employee orientation, I tell my staff that no matter what they bring to this job, they’re facilitators of someone else’s dream. They have to listen to the voice of the person who they’re trying to help, because change will only happen if they want it to happen. That’s why it’s the power of their choice – the power of their voice – that’s going to drive the change. Our goal is that one day they won’t need us. That’s what our mission statement is all about. We listen to their choices and stick with them as they make small changes, small accomplishments, and we celebrate those.

How did NSO first get involved with the Detroit URC? What do you gain from serving on the Detroit URC Board?

We got involved with the Detroit URC because of Dr. Richard Lichtenstein, who has been on the NSO Board for many years, and he’s now the Board chair. The University of Michigan proposed to do some research at NSO, and initially my staff rejected the proposal. What we had experienced in the past was that researchers would come to a nonprofit to study some issue, some problem – and they would leave the agency the same way they found it. There was no benefit to the agency. So that’s why we initially rejected the proposed research.

Richard eventually got us involved with the first CBPR project we did to get children enrolled in Medicaid and health care. We formed a partnership with University of Michigan researchers to identify what the challenges and roadblocks were, and then we went after a grant together. Not only did the researchers come – that was so powerful – but when we got the grant together, we also worked together to get the children health care. We saw major outcomes from that partnership – Richard’s such an advocate for that.

In fact, Richard and I presented at a conference together and talked about the role that researchers can have – and should have – when they come into a community to study a problem. Part of a researcher’s responsibility is to help the community organization find ways to put solutions in place to solve the problem that has been identified.

We have a very high-poverty population, and the Detroit URC is doing work in poverty-reduction, which is a big bite. Being on the Detroit URC Board, and being part of an entity that values the work community organizations do, is important. The resources that a researcher has can help to tell the story of the issues in the community. Then we can address it because there’s data – and you can go find funding to put programming in place around the problem. Researchers with the Detroit URC are not just coming in and taking the data and going back to their school – they’re helping gather the data to get the resources to address the problem.

What initiatives are you currently working on? What are your goals for the next year?

At NSO, we’re focused on housing development, health care, and youth services to name a few. We have a new low-income housing tax credit award through the help of the mayor and the governor, so we’re going to be building housing. We’re also going to redesign our shelter program. We know that women with children are a major population that cannot find shelter, so we are going to be moving our shelter into a new facility and change our focus to women with children. We also want to accommodate fathers with custody of their children. They cannot find many places to go if they are homeless, so I want to make sure we can find room in our facility so we can accommodate them. It’s all about ending homelessness and getting you back into the workforce.

NSO is also continuing to work in the health care arena, especially as the state is moving toward rolling behavioral health under Medicaid. There are three pilots that are going to be working in that arena, but none of them are in southeast Michigan, which concerns us. We recognize that this change will probably occur and we have some concerns, there’s an opportunity to educate Medicaid health plans around behavioral health challenges that they have not had to address with our special populations. We want to help the Medicaid health plans to understand the value of the behavioral health providers that have been doing this work for years in the community.

Finally, we’re working with youth in leadership development programs, and also workforce development. We work with high school students in both arenas, and try to get them motivated to go on to higher education – whether it’s job training or college. We’re running into major problems with kids who are just not motivated. If you don’t have a role model in your day-to-day life who has walked this path, then you’re not going to see the benefit. That’s a major challenge – and a challenge we’re ready to accept. It’s really important to me that we try to break the cycle of intergenerational poverty. We chose to work through the young people to break the cycle of poverty in their families. That’s where our focus is in terms of poverty reduction and why the workforce development program is so critical. We’re really trying to give some hope and solid futures to our youth.

A new study from the Healthy Environments Partnership finds that increases in self-reported discrimination against black and Latina/o adults corresponds to increased blood pressure – putting these populations at higher risk for cardiovascular disease. Learn more about this publication.

Four 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 ninth round of the small planning grant program. We are pleased to acknowledge the support provided this year by the University of Michigan Vice Provost for Global Engagement and Interdisciplinary Academic Affairs and the Michigan Institute for Clinical & Health Research (MICHR) Communities Engagement Program.

Funded partnerships are:

Enhancing Purpose-in-Life among At-Risk Latino Adolescents (EARL)

For decades, Detroit has been a city distressed by poverty, corruption, gang activities, family and community violence, and racial tensions. Issues of hopelessness and a lack of purpose in life combine with traumatic experiences to limit productive engagement by Latino youth in their communities. Without a robust sense of purpose in life, Latino youth in distressed settings such as Detroit are likely to remain disconnected in society.

The goal of Project EARL is to identify a mechanism by which a sense of purpose in life can be enhanced among at-risk Latino adolescents enrolled in one or more of Detroit Hispanic Development Corporation’s (DHDC) programs (Joven Noble, Urban Academy, Robotics Engineering, and Environmental Engagement, Advocacy and Leadership). The objective is to conduct an experimental study that examines the effects of the Myers Briggs Type Indicator (MBTI) assessment and related Career Report on purpose in life among DHDC program participants. The MBTI Career Report applies a person’s reported type from the MBTI assessment to relevant job families and occupations identified through previous research. The MBTI Career Report will not only help Latino youth understand themselves better by learning about their perception and judgment preferences, but also how those preferences are related to their occupational interests.

Angela Reyes

Executive Director

Detroit Hispanic Development Corporation

Ruben Martinez

Director, Julian Samora Research Institute

Michigan State University

Partnership for Transgender Health and Resilience in Detroit

While the visibility of Transgender and Gender Nonconforming (TGNC) communities has increased in recent years, they remain one of the most vulnerable populations in the United States and Michigan.

In order to develop and implement culturally appropriate public health interventions for TGNC youth and young adults, researchers must work in collaboration with TGNC individuals and community-based organizations (CBOs) that serve this population. This community-academic partnership between Trans Sistas of Color Project-Detroit (TSoCP) and researchers at the University of Michigan School of Public Health (UMSPH) furthers this area of research. This community-academic partnership will allow for community-engaged research that prioritizes areas of unmet need among TGNC young people in Detroit, while building the research capacity of a grassroots CBO that serves TGNC communities in Detroit.

Bré Anne Campbell

Executive Director

Trans Sistas of Color Project

Gary W. Harper

Professor, Health Behavior and Health Education

University of Michigan School of Public Health

Partnership Formation in Community-Engaged Work: The Detroit Food Academy

From cooking delicious healthy meals for friends and family, to facilitating complex conversations with community, to developing artisanal food projects from scratch to market, students of the Detroit Food Academy (DFA) learn by transforming their ideas into reality. By developing food-based solutions in and for their communities, students learn how to identify problems, implement solutions, and grow as holistic leaders who are healthy, connected, and powerful to affect change within and beyond the local food system.

A recently-formed partnership with the University of Michigan School of Social Work will examine and enhance the impact of the DFA through a strategic process of analysis and evaluation. The goal of this partnership is to collaboratively identify the organization’s most pressing technical challenges and develop processes that will not only enhance the organization’s day-today productivity but also prepare them for future growth. Together, the team will evaluate current capacities, conduct preliminary analyses and develop support systems to improve future decision-making processes.

Jen Rusciano

Executive Director

Detroit Food Academy

Emily Nicklett

Associate Professor of Social Work

University of Michigan

Exploring Research Partnership Opportunities: Youth Development Programming Impact on Neighborhood Social Conditions

Youth need access to safe environments, trusting adults, and opportunities for learning and support in order for to succeed in achieving positive and productive futures. Developing a new partnership, Urban Neighborhood Initiatives (UNI), a nonprofit community development organization providing youth development programming, will work with the University of Michigan’s Youth Policy Lab to measure improvements in the social condition of the Springwells neighborhood of Southwest Detroit.

In order to affect positive change, UNI has invested heavily in a complex network of groups supporting young people in the Springwells neighborhood, including parents, teachers, schools, neighborhood block clubs, and nonprofits. In partnering with the Youth Policy Lab, new work will explore the ways to measure the impact of youth programs on improving the social conditions of the neighborhood as a whole. The partnership will determine areas of opportunity for collaboration, reach out to other potential partners to join the group, and seek clear areas for collaborative research.

Christine Bell

Executive Director

Urban Neighborhood Initiatives

Robin Jacob

Co-Director

University of Michigan Youth Policy Lab

The Detroit URC is a partnership of representatives from the Detroit Health Department, Henry Ford Health System, nine community-based organizations (CBOs) in Detroit, and faculty members from the U-M Schools of Public Health, Social Work, and Nursing. The CBOs are: Communities In Schools; the Community Health and Social Services Center, Inc.; Detroit Hispanic Development Corporation; Detroiters Working for Environmental Justice; Eastside Community Network; Friends of Parkside; Institute for Population Health; Latino Family Services; and Neighborhood Service Organization.