By Ashley Edwards

Recently, The Nations’ Health, a publication of the American Public Health Association, featured Dr. Mouhanad Hammami in an article written by Kim Krisberg titled “Shift toward social determinants transforming public health work: Targeting causes of health disparities.” Below is an insert of the article.

“We wanted to focus on education, employment, social isolation, structural racism — all those factors combined correlate to an unfavorable birth outcome and the chances of a child not celebrating his or her first birthday,” Dr. Hammami, a member of the APHA and director of the Wayne County Department of Health, Veterans and Community Wellness, told The Nation’s Health. “What happens from the time a girl is born to the time she has a child?” Dr. Hammami also serves as co-chair of the Population Health Council, and the Detroit Regional Health Collaborative.

The Wayne County approach is complex, slow moving and requires buy-in from multiple sectors, but Dr. Hammami said public health “cannot continue to do business as usual.” Among the first steps, he said, was reaching across sectors to educate public officials about their role in health. For instance, when Dr. Hammami first asked local transportation authorities for help in reducing infant mortality, he said “they laughed — they said ‘we’re not a health department.’” But he persisted, explaining that for many women, transportation was a major barrier to prenatal care. Now, health and transportation officials work together to make women aware of their transportation options, such as shuttles that can be scheduled in advance.

The prenatal transportation initiative was just the beginning. This year, the health department has begun to integrate the social determinants of health in all of its programs. Dr. Hammami called the new working philosophy “no wrong door.” In other words, regardless of why people visit the health department, staff can assess their social needs and help them access services, such as Head Start or housing assistance. The agency also has a newly established a Social Wellness Program, which is charged with creating a delivery model that acknowledges and confronts the health impacts of racism and discrimination.

“We can’t approach a person in sections and silos,” Dr. Hammami told The Nation’s Health. “We’ve become so overspecialized…we’ve lost the authority to be truly what we should be: the guardians of people’s health. Our plan is to reclaim that authority.”

For more information and to read the entire article please visit http://thenationshealth.aphapublications.org/content/46/5/1.3.full

Ashley Edwards is the 2016-17 W.K. Kellogg Population Health Fellow.