By Loretta Davis and john a. powell
Last year, “Detroit Future City,” the Detroit Strategic Framework, was released and presented throughout the city. The plan offers a reasoned approach to redesigning a smaller city, specifically as it addresses the need to promote sustainable residential neighborhoods and quality of life. The underlying cohesion is the health of the population: An economically viable Detroit begins with healthy neighborhoods.
The Detroit Strategic Framework recommends that neighborhoods be measured by 13 quality of life indicators: safety, education, housing, environmental quality, prosperity and income, sense of community, physical condition of the built and natural environment, personal mobility, recreation, culture, retail services, and “health,” among others. However, all of these are integral to what we refer to as “population health.”
Population health is a discipline that links traditional public health services with many aspects of life not normally associated with health, such as public safety, transportation, and housing. However, one’s health is strongly influenced by “social determinants,” and if you live in a vulnerable community, those determinants may be overwhelmingly detrimental to your health.
As the 2013 Robert Wood Johnson Foundation County Health Rankings www.countyhealthrankings.org/app indicate, Wayne County ranks lowest on most health indicators, largely a reflection of the health status of Detroiters. While the methodology may be challenged, the fact is the health of our community is severely distressed, which reflects in health care costs, educational performance, and productivity. Wayne County ranks 81st and 82nd in Michigan for mortality and morbidity. After taking into account the health indicators, most social, economic, and physical environment indicators are well below national benchmarks.
Arguably, the first order of business in restoring the economic vitality of Detroit should be restoring the health of its population.
The Population Health Council, sponsored by the Detroit Wayne County Health Authority, works with stakeholders in all areas that impact the health of the community, as well as the well-being of specific vulnerable populations. While the heart of our work expands and supports traditional public health, we integrate other stakeholders to achieve a more comprehensive analysis and approach to health improvement.
We welcome the support of public health representatives from Oakland and Macomb counties, representatives from the State of Michigan Department of Community Health, local health and environmental advocates, public safety, housing, economic, and academic scholars – all of whom share a commitment to Detroit, Wayne County, and the Southeast Michigan region. The health challenges of Detroiters, complex and serious as they are, can be reflected in other Michigan communities and the overall quality of life in our state.
The national “Place Matters” program articulates the notion that racial and ethnic health inequities result in higher rates of infant mortality, chronic and infectious diseases, disability, and premature mortality among many minority groups relative to national averages. The root cause, according to a growing body of research, is the place in which people live and work.
While we look at health disparities and the social determinants of health, our goal is improving the health of the entire population, not just achieving equity for disenfranchised groups who may live in less desirable areas.
The fate of Detroit Future City is linked to the future Southeast Michigan. The air, water, and soil are shared by all. Conditions like obesity, diabetes, and heart disease cross all demographics.
We need to apply a health lens to sharpen our economic vision. Simply put, a healthy citizen is a productive citizen.
Loretta Davis is president of the Institute for Population Health, Detroit, and former co-chair of the Population Health Council
john a. powell is executive director of the Haas Center for Diversity and Inclusion at the University of California – Berkeley and co-chair of the Population Health Council