Findings, Becoming Detroit - An inside look at a city's metamorphosis, Spring 2015 by University of Michigan School of Public Health

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Becoming Detroit An inside look at a city’s metamorphosis

INSIDE

> A former auto worker looks to the future p. 18 | A city grows p. 26 | The D’s healthy new food scene p. 52

View of Detroit in 1836 (detail), 1836 or 1837 William James Bennett American, 1787-1844 oil on canvas Detroit Institute of Arts Gift of the Fred Sanders Company in memory of its founder, Fred Sanders

By 1836, the date of this painting, Detroit had several thousand residents—largely a mixture of French, German, and Irish. Most of its streets were wooden plank, but downtown the streets were cobblestone. Mail service connected the young city to the east coast, and daily stagecoaches ran between Detroit and Chicago. By 1840, Detroit’s population had grown to more than 9,000, and Michigan Territory had become the nation’s 26th state.

A brief history of the city’s evolving demographics by Jeff Mortimer

1701: Frenchman Antoine de la Mothe Cadillac and his party of soldiers and fur traders are the first recorded European settlers. Cadillac oversees the construction of Fort Ponchartrain (right), establishes a settlement within its walls, and invites the region’s native people to live near, but not in, the compound.

1751: The first German in the area, Michael Yax, starts farming in what is now Grosse Pointe. Detroit Historical Museum

We Are Detroit

1763: The French cede Detroit to Great Britain as part of the treaty that ends the French and Indian War.

1793: Jacob Young purchases property from a French settler, becoming the first black person to own land in Detroit.

Detroit Historical Museum

Bentley Historical Library

From 1841 to 1891, Cadillac Square was home to the Detroit farmers market. By the time this photo was taken, ca. 1880, significant numbers of Italian and Polish immigrants were moving to the rapidly growing city.

Adelaide DeQuindre’s (left) marriage to Detroit landowner Joseph Campau combines two local French families, but they live to see Detroit become dominated by non-French populations.

1796: Two-thirds of Detroiters are French. Dutch, Germans, and enslaved African-Americans also live here. 1825: The first wave of German immigration to Detroit begins, as the opening of the Erie Canal greatly eases travel from the eastern U.S. to the Great Lakes.

1830: Irish immigrants begin settling west of Woodward Avenue in a neighborhood they call Corktown (most of them are from County Cork), now the city’s oldest.

1830s: Germans are the first Europeans to settle the area now known as Greektown. Along with Polish immigrants, they are a major source of population growth from the 1860s to the 1890s; for decades, Germans comprise the city’s largest ethnic group.

Mario Tomba/Getty Images

Photo from the Frank Wendt and Elizabeth Przytulska Collection. The photo was featured in Polish Mission publication and exhibition Portrait Studios of Detroit’s Polonia: The Face of Polish Immigration, by Dr. Hal Learman and Ceil Wendt Jensen, Orchard Lake, Michigan (2014).

In the late 19th and early 20th centuries, professional and amateur photographers alike documented life in metro Detroit’s thriving Polish communities on the city’s eastside, westside, and in Hamtramck. Portraits like this one, ca. 1905, from the F.G. Poli studio, were intended both for immediate family in metro Detroit and for exchange with relatives living in Poland.

Left: Students at Saints Peter and Paul Academy, a grade school in an Irish Catholic parish on Parsons St., ca. 1905 Right: Italian produce vendor at Eastern Market, ca. 1900

1840s: Waves of Irish arrive in the wake of the Great Irish Potato Famine. 1855: Italian immigrants begin settling on the east side of the city. 1857: Polish immigrants begin arriving in large numbers.

Early 1870s: The first Middle Eastern settlers in the Detroit area are Lebanese, most of them Christians. 1880: Over 40 nationalities are represented in Detroit’s population of 116,342 in the U.S. Census.

Clements Library, University of Michigan

Among the flood of immigrants to come to Detroit in the early 20th century in pursuit of a better life were Armenians, such as these shoemakers at work in Leon G. Nahnikian’s shoe repair and tailor shop, on Henry Street, ca. 1917.

1890-1914: A new wave of Italian immigrants arrives. Bentley Historical Library

Right: Maltese immigrants at an Americanization meeting in a private home on Michigan Ave., 1920

Late 1890s: Greek immigration begins, peaking in 1910–1914. 1914: The Ford Motor Company announces that instead of $2.34 for nine hours’ labor, most workers will make $5 for eight hours.

1917: Spurred by the availability of jobs due to the departure of workers for service in World War I, African Americans arrive in Detroit at the rate of 1,000 per month throughout the summer, part of “The Great Migration” of African Americans from the rural South to northern industrial cities.

Burton Historical Collection

On September 14, 1930, noted Detroit photographer Harvey C. Jackson took this photograph of the medical staff, trustee board, and corps of nurses of Dunbar Memorial Hospital. Opened in 1917 and named for the poet Paul Laurence Dunbar, Dunbar Memorial was the first hospital for African Americans in Detroit. The original hospital building, at 580 Frederick Street, is now a museum and headquarters for the Detroit Medical Society.

Right: A Chinese worker in the Hudson Motor Car plant, working on Curtis dive bombers, 1944

Walter P. Reuther Library

1930: Nine thousand Arabic speakers are among the residents of Detroit; 6,000 of them are Syrians.

Left: Syrian fruit vendors in Detroit, ca. 1920s Walter P. Reuther Library

1920: Detroitâ&#x20AC;&#x2122;s population is 993,678, up 113 percent from 1910. African Americans make up 4.1 percent of the total, a 611 percent increase over the same time span.

1940s: Mexicans begin settling southwest of Corktown, in what is now known as Mexicantown. In 2010, Detroit has 48,679 Hispanics, a 70 percent increase from 1990.

Left: An ArabAmerican business owner, Vernor-DixWyoming area, ca. 1982 Right: Latino students at Webster Elementary in Southwest Detroit, 1981

Walter P. Reuther Library

1940–1970: Some historians refer to this period as “The Second Great Migration.” More than 66 percent of Detroit’s black population in 1950 comes from outside the area. Many people from Appalachia also settle in the city after World War II.

Walter P. Reuther Library

The work of Chilean artist Dasic Fernandez, this mural on the side of Detroit’s Hacienda Mexican Foods building (6022 W. Vernor Highway) is known as Mano de Obra Campesina. Fernandez wanted to create an image to suggest the labor that goes into the production of people’s daily food, especially in Mexicantown.

1950: Detroit’s population reaches its height to date at 1.85 million. About 55,000 are of Middle Eastern ancestry. 1980: Sixty-three percent of Detroit’s population is AfricanAmerican, the first time the U.S. Census shows them in the majority.

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42 Turning Points

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52 Food City

In April, the School of Public Health launched its first-ever national marketing campaign. The result of extensive research about the school’s identity and how best to position U-M SPH in the national conversation around global public health issues, the campaign adopts the tagline “Doing a World of Good.” The advertisement shown here is one of two major pieces that launched the campaign, featuring Dean Martin Philbert. The first ads appeared in The Economist, The Wall Street Journal, and The Atlantic. Future advertisements will feature faculty, students, and alumni, and will run in other publications, websites, and social media channels, and via search engines. Details are at sph.umich.edu/worldofgood.

findings Volume 30, Number 2 Spring/Summer 2015 Produced by the U-M SPH Office of Marketing and Communications

20 Fe ature Articles

Becoming Detroit 18

Writing Detroit

A post-industrial city draws energy from its automotive past.

Seeing Detroit

In the storied neighborhood of Brightmoor, the word “care” has many meanings.

Being Detroit

From forts to factories, 300 years in the life of Michigan’s biggest town.

Leading Detroit

A new generation takes on one of public health’s oldest challenges.

S pecial S ection V i c t o r s f o r m i c h i g a n c a m p a i g n

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FROM THE DEAN

A Bright Future

Detroit Food Academy

n important ways, the city of Detroit is a bellwether. Like Among the durable threads of history that have persisted through many American cities, it was hard hit by the globalization good times and bad are the abiding relationships between members of the of markets and labor in the late 20th century, and further Detroit community and the University of Michigan School of Public Health. battered by the Great Recession of 2008. As the first major These relationships have enriched our collective understanding of what we American city to file for bankruptcy, Detroit can be considered can—and must—do to reduce health disparities and expand access to care a cautionary tale for the nation. That’s why its future matters in urban settings. Through their resilience, ingenuity, and commitment, so much. Detroit reminds us that cities are living organisms, our Detroit partners have been nothing short of inspirational to us all, and and the only way they can succeed is if their residents are it’s no accident that so many members of the SPH community—students, engaged in a healthy economy, live in healthy neighborhoods, graduates, faculty, and staff—are today working for Detroit’s future. Martin Philbert and have access to first-rate health care and to safe, healthy, A vibrant Detroit depends on the promise of a thriving, forward-lookaffordable food and water. ing, 21st-century metropolitan area. It depends on the strategic investment The durable threads of Detroit’s long and rich history are readily disin the education of young people, and on the creation of a robust and fertile cernible, and they’re being woven into a bright future, not only for Detroit environment where those young people can stay healthy and engaged, but for southeastern Michigan and, indeed, for the entire state. The earliest through good times and bad, spring and, yes, even our bright, crisp winters. of those threads include the To eliminate inequities, we Native Americans who recoghave to build new economies nized the area’s potential for and enterprises that allow hunting, fishing, planting, and people to do good and do well. trade, and the French explorers I am deeply encouraged by the who, after navigating the St. concentration of new entreLawrence Seaway, found in le preneurs in Detroit who are détroit du Lac Érié (“strait of bound by a triple bottom line. Lake Erie”) a place to exchange They seek profit, yes, but only goods and build commerce. if it comes with environmental Detroit has always been sustainability and social equity. a place of promise. It’s the They realize that it is no longer birthplace of the mass-proacceptable for us to consign one duced automobile and of the segment of the population to original “catholepistemiad, living in substandard housing or university, of Michigaand polluted neighborhoods nia,” later the University of so that another sector can get Michigan. As a terminus on rich. By example, they remind the Underground Railroad, us of the biblical injunction Detroit was a symbol of hope that all of us bear responsibility A vibrant Detroit depends on the strategic investand economic opportunity for “the least among us.” Of for countless Americans fleethe many important lessons ment in the education of young people, and on the ing slavery. A century later, Detroit has to teach, this is percreation of a robust and fertile environment where the city gave rise to a thriving haps the greatest. those young people can stay healthy and engaged. middle class of color—one And so in this season of of the country’s first. Many renewal, I am filled with optiin that community came here as part of the Great Migration, itself a mism. Optimism that Detroit will fulfill its legacy of promise as a place movement shaped by hope and opportunity. of shining opportunity for workers, the middle class, the struggling Michigan’s largest city has historically been a model for what can and poor, and enterprising entrepreneurs. Optimism that the numerous and what ought to be. As a mid-century emblem of middle-class African-Amervaried efforts across Detroit to build health and community will enrich ican prosperity, Detroit refuted the idea that blacks lived only in ghettos or and enhance each other and, along with the city’s world-class arts and rural areas. Long before “diversity” became a mantra, Detroit exemplified music and food and sports, help to make Detroit once again one of the the term, as evidenced by its many houses of worship representing comnation’s most desirable places to live. < munities of faith from places as disparate as the United Arab Emirates, the Martin Philbert Caribbean, and the American South—not to mention Michigan. Dean and Professor of Toxicology

FROM OUR READERS > I found “Our Moral Imperative” (fall/winter 2014) truly inspiring. As a local public health professional, I am confronted daily with not only “the eternal struggle—between what is ... and what ought to be,” but also with the reality that we are sometimes the ones who make it difficult to adopt and implement solutions.

Our moral imperative is relevant in a teaching context as well

> As always, I read the latest issue of Findings (“What Does It Take to Change the World?” fall/winter 2014) with interest and enjoyment, including the dean’s letter about “Our Moral Imperative.” Two things jumped out to me. The first was Dean Martin Philbert’s observation that “the richer we have become materially, the

Leseliey Welch, MPH ’04, MBA, ’12 Lecturer, Women’s Studies, U-M Ann Arbor, Michigan

It is a very disconcerting realization to an optimist who entered the field to be a part of love, compassion, and justice in practice, program, and policy for the betterment of health. Why do we serve, if not to overcome the “isness” of injustice, ego politics, divisiveness, misplaced priorities, and the failure of systems to produce the outcomes they were created to ensure? Our moral imperative is relevant in a teaching context as well. As a university lecturer, I am grateful for the opportunity to engage students around feminist values in management and leadership practice across sectors. One of the challenges I have encoun-

Since I’ve graduated from SPH, there have been times of frustration, times of wondering whether I’ve entered the right field. >I was greatly moved by Dean Philbert’s letter on “Our Moral Imperative” (and not just because I’m a big fan of both Martins mentioned!). Over the years since I’ve graduated from SPH, Photos: Bentley Historical Library, News and Information Services Collection

Our Moral Imperative

to accept the limitations of what is and a commitment to creating what ought to be? No matter what we are confronted with— in our daily work or in a feminist-practice case study—recognizing our interconnectedness, deciding, investing, and acting (within whatever our spheres of influence may be) on our moral imperative is paramount to becoming who and how we ought to be in theory, practice, and in health. Dean Philbert’s letter was an eloquent reminder and affirmation of this for me, for which I am sincerely grateful.

Dean Philbert also cited a Martin Luther King quote that I had not seen before: “In the final analysis the rich must not ignore the poor, because both rich and poor are tied in a single garment of destiny.” poorer we have become morally and spiritually.” That, like all truth, is not only profound, but attractive. Dean Philbert also cited a Martin Luther King quote that I had not seen before: “In the final analysis the rich must not ignore the poor, because both rich and poor are tied in a single garment of destiny.” What a wonderful word picture and powerful truth. It reminds me of a quote from the writings of Ellen G. White: “It is character that decides destiny” (Christ’s Object Lessons, p. 74). My continued appreciation for Findings. You have some very talented people putting that together. It is excellence! Richard Lane, MHA ’65 Livonia, Michigan

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Martin Luther King, Jr. visited Ann Arbor in 1962 and delivered a speech at Hill Auditorium. tered is that we do a great job teaching our students how to think critically and analyze problems, but a less than exemplary job teaching and nurturing in them the intangible skills and political savvy necessary to successfully execute “swift and even vehement” responses to injustice, influence others across difference, and/or “gently shake the world.” Recently, I quoted “Our Moral Imperative” in a discussion with my students about the importance of quality of care to a case-study organization facing community and political challenges. Dean Philbert’s letter speaks to the heart of feminist practice. What is feminism (or any social justice movement) if not a refusal

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there have been times of frustration, times of wondering whether I’ve entered the right field. Thank you for the reminder that although we don’t often see that huge breakthrough—that huge change we’re striving for—“gentle shaking” is important and makes a difference. Thank you for a beautiful piece of writing. Susan Batts Sutorka, MPH ’04 Project Specialist, Strategic Initiatives, MHealthy Ann Arbor, Michigan

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Big Data

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> Almost 50 years ago, I sat in a classroom at

> I am one of your grateful readers, though it

SPH as Vlado Getting [then–professor of public health administration] taught our class that in Massachusetts every dog bite required the completion of a three-page questionnaire—but the only information that actually trickled up to the director of public health was the number of dog bites. The recent Findings article by Peter Song on “10 Ways ‘Big Data’ Is Changing the Way We do Public Health” (fall/winter 2014) gives me some hope that perhaps all this data I have been collecting and submitting over the last half century is finally being examined and even perhaps used.

is many years since I had the good fortune to attend SPH. I appreciate receiving Findings and read and study all the articles. In my opinion it is as good as any medical journal. I cherish my memories of SPH, the professors and staff. I recall with pleasure meeting and listening to Professor Sy Axelrod—a first-class lecturer. I remember with pleasure Professor Richard Remington, also a very good teacher. I had the very best graduate education from U-M and SPH that one could hope for. I devour with interest all that SPH is involved in, whether at home or abroad. Keep it up!

Alan Bloom, MPH ’70 Vice President of Legal and Regulatory Services; Registered In-House Counsel, Care1st Health Plan Monterey Park, California

Jack Rowe, MPH ’58 Victoria, British Columbia

Findings is published twice each year by the University of Michigan School of Public Health Office of Marketing and Communications. Dean Martin Philbert Director of Marketing and Communications Rhonda DeLong Editor Leslie Stainton Video Editor Brian Lillie Web Editor Beth Miller Web Administrator Patty Bradley Art Direction/Design Hammond Design Business Manager Rebecca Minch

Copies of Findings may be ordered from the editor. Articles that appear in Findings may be reprinted by obtaining the editor’s permission. Send correspondence to Editor, Findings, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109-2029, or phone 734.936.1246, or send an e-mail to sph.findings@umich.edu. Findings is available online at sph.umich.edu/ findings. ©2015, University of Michigan To opt out of receiving the print version of Findings and read our publication exclusively online at sph.umich.edu/findings/, e-mail us at sph.optout@umich.edu. Include Opt-Out in the subject line and your full name in the text.

Regents of the University of Michigan Michael J. Behm, Grand Blanc Mark J. Bernstein, Ann Arbor Laurence B. Deitch, Bloomfield Hills Shauna Ryder Diggs, Grosse Pointe Denise Ilitch, Bingham Farms Andrea Fischer Newman, Ann Arbor Andrew C. Richner, Grosse Pointe Park Katherine E. White, Ann Arbor Mark S. Schlissel, ex officio

Marc-Grégor Campredon, whose photos grace the pages of the award-winning fall/winter 2014 issue of Findings, captured this image of SPH students eagerly reading the issue shortly after its publication last year. Campredon is married to SPH epidemiology student Lora Campredon (MPH ’15).

We love hearing from you! Post comments online; e-mail us at sph.findings@umich.edu; or send a letter to Findings, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109-2029; fax 734.763.5455. Comments may be edited for length and clarity.

R e c e n t A wards The fall/winter 2014 issue of Findings (“What Does It Take to Change the World?”) won both a Gold Award and a Judge’s Choice Award in

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Back issues of Findings are available upon request. Visit sph.umich.edu/findings to review past issues. To request print copies, specify which issue and e-mail sph.findings@ umich.edu.

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Detroit: An Environmental Tour

On the Heights

People know Detroit as a car town, but there’s lots more to Michigan’s largest city, says SPH Professor Stuart Batterman, who helps lead an annual tour of Detroit for U-M students and faculty and other interested Ann Arborites. Sponsored by the U-M Center for Occupational Health and Safety Engineering, the annual day-long event offers a first-hand look at the city’s environmental issues. The itinerary varies from year to year but always includes major sources of pollution, such as the Detroit incinerator, as well as more upbeat sites, like Eastern Market (shown here) and the city’s wastewater treatment plant—the largest in the U.S., says Batterman. “Downsizing hit Detroit harder than other rustbelt cities,” he notes, “but at the same time there’s a great spirit, and a lot of good stuff is happening.” W For a video on the annual Detroit tour see sph.edu/findings/.

To Vaccinate or Not

Detroit in the Classroom

U-M and Detroit: 198 Years

Now We Are Six

An Unlikely Explorer

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O n the H e i g h t s The U-M SPH Graduate Summer Session in Epidemiology (GSS) marks its 50th anniversary this year with a series of special events, including a symposium on chronic disease (July 22) and a keynote address (July 29) by Jonathan M. Samet, MD, MS. Samet is a Distinguished Professor and the Flora L. Thorton Chair of the Department of Preventive Medicine, Keck School of Medicine, University of Southern California, and director of the USC Institute for Global Health. “Attending the summer session as a graduate student in 1975 strongly influenced my decision to become an epidemiologist,” says SPH Professor Hal Morgenstern, who now directs the internationally acclaimed program. “And I’m sure it’s shaped the careers of countless others over the past 50 years.” n In just 24 hours, SPH colleagues, friends, and alumni raised $42,412 online during U-M’s first-ever Giving Blueday. Held December 2, 2014, Giving Blueday was part of the university-wide Victors campaign. The majority of funds raised for SPH will support student scholarships, said SPH Dean Martin Philbert, noting that scholarships “are often the pivotal factor in making their SPH education possible.” For more on the school’s campaign—and to read SPH student stories— visit sph.umich.edu/giving. n The editorial office of the American Journal of Preventive Medicine is now based at U-M SPH, under the direction of Editor-in-Chief Matthew Boulton, professor of epidemiology and senior associate dean for global public health. Considered by many to be the world’s leading journal on prevention science and policy, AJPM has more than 10,000 print and electronic subscribers and receives over 90,000 article views per month on its website, many from primary care providers. “Under the Affordable Care Act, primary care physicians are being paid to use prevention to keep people healthier,” Boulton notes. “So our time has come.” The new editorial team has expanded the journal’s scope to include topics like injury prevention, LGBT health, immunizations, substance abuse, mental health, and the integration of primary care and public health. n

To Vaccinate or Not? An episode of NOVA sheds light on the issue—and spotlights SPH faculty.

ith confirmed cases of measles in Michigan’s Oakland County earlier this year, and passage in 2014 of the state’s vaccine waiver law, vaccines will be an important local issue for the foreseeable future. U-M SPH Associate Professor Brian Zikmund-Fisher, whose research focuses on risk communication, has been studying parental perceptions of vaccines for years. Back in 2011, a post about vaccine communications for the U-M Risk Science Center blog led to an invitation for Zikmund-Fisher to serve as an expert for an Australian documentary on vaccines titled JABBED, which was subsequently turned into an episode of the PBS television series NOVA. The episode, “Vaccines: Calling the Shots,” aired last September. Zikmund-Fisher talked to SPH student Peggy Korpela about the experience:

In the NOVA episode, several mothers express uncertainty about vaccinating their children. How did the episode try to speak to such parents? Public health tends to dismiss concerns about vaccines by reiterating that vaccines are “safe,” but such messages fail to acknowledge parents’ feelings. The NOVA episode acknowledged that risks involved with vaccines exist but are rare at a population level, while reminding viewers that individual parents may reasonably worry whether their child “is that one in a million.” The episode tried to convey empathy for such fears while using images of Michigan Stadium to show concretely just how small one in a million is.

“Someone with measles can be in Russia or France one day and behind us in line at Starbucks the next day.”

What motivated you to contribute to the film? Vaccines are perhaps the single largest public health risk communication. Yet, talking about vaccines is different today than it was in 1965. Sixty years ago, public health didn’t have to sell the value of vaccines because people regularly experienced the threat of measles, polio, and pertussis. Epidemics weren’t temporary crises—they were permanent parts of everyday life. Today, most parents lack first-hand experience with communicable diseases. That’s what makes communicating about vaccines so hard, yet so important.

More importantly, the episode presented personal stories of measles, polio, and pertussis—stories that reminded viewers why we vaccinate, despite the rare risks. For example, while measles is not (yet) a regular occurrence here in the U.S., that’s not the case elsewhere. Someone with measles can be in Russia or France one day and behind us in line at Starbucks the next day. So protecting ourselves and our communities via vaccination remains essential. < To view the episode, visit sph.umich.edu/ findings.

On the Heights

>Syllabus:

PubHealth 600 Cross-Disciplinary Approaches to Public Health Challenges Focus: Detroit Professor Eden Wells, Clinical Associate Professor, Epidemiology Course description: Students are introduced to basic principles and perspectives across three disciplines (environmental health sciences, health behavior and health education, health management and policy) and learn to integrate and apply these resources to address complex public health problems. Case studies in the winter 2015 term are drawn primarily from the city of Detroit. Topics include: Environmental health issues (including asthma and access to healthy foods), principles of community-based participatory research, health impact assessments; public health advocacy, the regulatory environment; health literacy, cardiovascular health inequities.

Says the professor: I chose Detroit as a focus of the class because I want students to see that in Detroit, like any urban area, public health issues are more apparent. But I also want them to see the great collaborations and innovative interventions that are going on in Detroit, which they can add to. The students learn not only to understand specific public health issues and the factors that determine those issues, but also to think of novel points or types of

In the Classroom and on the Streets, Detroit Has Much to Teach “Even in SPH, a lot of people haven’t spent much time in Detroit, or just know vaguely about it,” says Doug Strane, MPH ’15, who served as a course assistant for this year’s PubHealth 600. “Having a solutions-driven course focused on Detroit gets people excited and makes them think about the city differently—which is really an important skill for public health in general.” Besides completing his MPH course work, Strane spent much of the last year working in Detroit on the health and environmental impacts of redevelopment. < Peter Smith

Semester-long assignment: Working in interdisciplinary groups, students define a public health challenge in Detroit; identify key issues and stakeholders; develop potential interventions; and determine how to engage governmental leaders, community residents, and other stakeholders.

intervention. <

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FINDINGS

U-M and Detroit: 198 B

efore moving to Ann Arbor in 1841, the University of Michigan health and at least 17 other U-M units—among them art and design, busiestablished its first home in Detroit in 1817. Nearly 200 years later, ness, engineering, social work, and urban planning—use the center for a the bond between U-M and the state’s largest city remains strong. broad range of activities, including information sessions, policy discusAs a founding partner in one of sions, performances, after-school the longest-standing U-M collaboand outreach programs, a summer rations in Detroit, the Detroit Comtheater camp, and a Hall of Fame munity–Academic Urban Research recognizing the achievements of Center (URC), the School of Public Detroiters who are U-M graduates. Health is a key participant in that relationship. Launched in 1995 with the aim of improving health through community-based participatory research—a framework that empowers residents to take action for their own health—the URC is a collaboration of ten Detroit-based organizaAnother focus of U-M’s engagetions, including both communityment with Detroit is the university’s based organizations and health and Semester in Detroit (SID) program, human services agencies. which “helps students form foundaThe center, which celebrates tions for long-term relationships its 20th anniversary this year, has with Detroit,” says Craig Regester, had a big impact on health policy associate director of the program. and behaviors throughout Detroit. One-third of Michigan undergraduU-M’s first home was in this building on Bates St. in downtown Detroit. Equally important, the URC has ates who spend a term in Detroit helped pave the way for a flowering of U-M–Detroit partnerships across through SID end up living there after graduation. Regester notes that a range of disciplines. Many of these partnerships utilize the university’s no matter how members of the U-M community are involved in Detroit— new midtown hub, the U-M Detroit Center, which functions as an office, whether as residents, researchers, students, or neighbors—“we are all speaker venue, gallery, and public meeting space. Groups from public dependent on the city’s well-being.” —Amy Gu < Bentley Historical Library

The URC has helped pave the way for a flowering of U-M– Detroit partnerships.

On the Heights

Years and Counting

U-M Activity in (and with) Detroit Hereâ&#x20AC;&#x2122;s a partial list of current partnerships and initiatives involving U-M and members of the Detroit community: A Mentors Summit: Paving the Path to College

Intellectual Minds Making a Difference

African Americans and Social Mobility in Detroit

Leadership and Public Service Fellowship

America Reads

Local Artists Under 10

Best Classroom Project

Memory and Aging Project

Community Action Against Asthma

Michigan Architecture Prep (ArcPrep)

Crowd 313

Michigan Engineering Zone

Detroit Community-Academic Urban Research Center

M Is 4 U

Detroit Connections

Project Healthy Schools

Detroit Entrepreneurship Network

REACH Detroit Partnership

The Detroit Initiative

School of Social Work Technical Assistance Center

The Detroit Partnership

Semester in Detroit

Detroit Revitalization and Business Initiative

Teach for America Certification Program

Detroiters Speak

U-M Libraryâ&#x20AC;&#x2122;s Detroit Center Program

Gear Up

Understanding Race Project

Genesis III Project

Walk Your Heart to Health

Healthy Environments Partnership

We Support Detroit Schools

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From the Archives

Now We Are

Nutritional Sciences in Alaska, ca. 1948

resh after receiving her MPH from Michigan in 1948, World War II veteran and Vermont native Penelope Easton set off for Alaska, where she spent two years as a dietary consultant for the Alaska Territorial Health Department. New to the region, Easton seized every chance she could to learn about Native Alaskan culture, especially food. She even grew to “like muktuk”— strips of whale skin and blubber—as the title of her new book, Learning to Like Muktuk: An Unlikely Explorer in Territorial Alaska (Oregon State University Press, 2014), indicates. Decades before “local and sustainable” became buzz words, Easton, now 91 and a resident of North Carolina, realized how vital it is for public health professionals to appreciate regional resources:

“I learned about the Native methods of preserving foods: the drying and smoking of fish, especially salmon; the preserving of berries in seal pokes; and the use of cold cellars dug in the permafrost. When meat and fish were plentiful, Native people consumed large portions. Berries and greens that were harvested in the summer and stored in sufficient quantities kept the people from starvation.

n January, U-M SPH established a new Department of Nutritional Sciences, based on the long-standing Human Nutrition Program in the Department of Environmental Health Sciences. The decision to form the school’s sixth department stemmed primarily from growing student interest and a deepening national emphasis on nutrition as a key to good health, says Karen Peterson, chair of the new department. In particular, the past decade has seen a dramatic increase in research and scholarship in the areas of obesity, chronic disease risks, food safety and security, global hunger and undernutrition, and the environmental and health impacts of food production. “These issues are inherently interdisciplinary and multidimensional,” Peterson explains, “and deep, broad collaboration will be a hallmark of our department.” The department’s curricular and experiential offerings span the gamut from nutrigenomics and epigenetics to the clinical and community translation of nutritional science. As of this fall, U-M students will be able to pursue MPH, MS, and PhD degrees in nutritional sciences. For more visit sph.umich.edu/ns. <

Hunters and gatherers in the villages gave shares of all harvested food to the young, old, and ill. My orientation to native foodways included information about the eating patterns that I was likely to find in villages, such as a communal stew or soup pot kept hot and available all day with no distinct meal times. Meats and fish were eaten completely, stomach contents, entrails, and all, supplying valuable and scarce nutrients.

The willingness of white people to discount the high level of native sophistication was still evident in the postwar, pre-statehood years. Rosehips were a great surprise. Although it was probably true that the tiny seedpods on our old-fashioned roses in Vermont were rich in vitamin C, we never suspected it. Somehow the natives discovered the curative values of the huge red-orange seedpods of Alaska roses. Children often ate rosehips directly from the plants as they ran through the countryside in the fall. Jellies or purees made from rosehips went a long way in preventing deficiencies in vitamin C for hundreds, maybe even thousands of Alaskans. Livers from fish and other animals were an important part of the native foodways. The willingness of white people to discount the high level of native sophistication was still evident in the post-war, pre-statehood years.” <

Becoming Detroit

Like the water from which it draws its name, Detroit is at once a physical entity and a phenomenon in constant motion.

Detail from Map of the Surveyed Part of the Territory of Michigan by O. Risdon 1825 Clements Library, University of Michigan

Since its first recorded mention in 1670, by French missionaries, this storied American site has been many things to many peopleâ&#x20AC;&#x201D; shelter, fort, farm, sanctuary, battleground, territorial capital, incipient city and industrial powerhouse, a magnet for musicians and a canvas for artists of all kinds. Nestled at the base of Michiganâ&#x20AC;&#x2122;s thumb, along a liquid seam that stitches together two nations and three great lakes, Detroit is a place of currents and connections. Above all, to the countless people from across the globe who over the course of three centuries have come here to live, work, and dream, it is home.

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The factory work ethic still permeates a city haunted by the ghosts of assembly lines past. And that’s good news for the future.

ne day in the early years of my career at General Motors, my father said to me, “You could have picked up the pen, but you picked up the hammer.” Who knows what misconceptions informed his understanding of factory, how low he thought I had sunk after receiving a degree from the University of Michigan. I was stunned that he made a distinction between pen and hammer, as though I had lost brain power upon entering the factory. But I hadn’t, at least not for that moment on my parents’ east side Detroit front porch. So, cheeky as ever, I replied that I had picked up both. Pen and hammer have defined my interaction with my city then and now. How I arrived at an auto factory with degree in hand is a mystery even to me. But I had happened upon some radical workers at just the time when not much else made sense during those chaotic years of the late ’60s and early ’70s. So I found myself working in a sure-nuff, big-time producer of the flagship symbol of American luxury, the Cadillac Motor Car Company. I was there to organize unionized workers to a higher level. Frankly, I mainly ended up organizing myself into writing poetry and fiction about life in the plant. I needed to figure out why, really, was I working in a factory? Why any of us were in there. For sure auto work is hard. You could find yourself lifting heavy in foundries, as my good friend and Ford worker General Baker did, or working mighty fast, as I did on the assembly line. Lifting heavy or working fast was really no different than the early days of auto production and equally wreaked havoc on the body, especially given the repetitive nature of both. In 1913 at the Rouge, the absentee rate was 10.5 percent with a 307 percent turnover, creating the need for a large pool of replacements. Hence, the advent of the $5 work day. Ford

lessened the cost of production by keeping a stable workforce, and provided the paycheck for workers to buy the product. 1 It was up to the workers to fight for health care, pension, and other benefits that are less and less available to workers now entering the field. Autoworkers of my day inherited a work ethic established by our predecessors. We became loyal to repetitive, heavy work and to lots of it. We became loyal to our nameplates, in spite of the physical pain of production and the diminution of emotional energy. The benefits helped to compensate for the rigors of factory labor and were, in part, the reason for our loyalty.

Pen and hammer have defined my interaction with my city then and now. Auto work was hard for the pioneers of Ford’s assembly lines and it was no cakewalk for me at Cadillac decades later. Evidently, it’s still hard in spite of cleaner conditions and air conditioning. That must have thrown off the 26 new hires at Chrysler’s Jefferson Assembly several summers ago; they expected easier working conditions, but quit on their first day at lunchtime. The work was too difficult at $14/hour.2 With reduced benefits, new workers don’t have the same loyalty.

by Lolita Hernandez

n his foreword to Working Words, a massive 2010 compilation of working-class literature edited by M. L. Liebler and published by Coffee House Press, Ben (Rivethead) Hamper writes, “The notion that work builds strong character strikes me as a defeat-

Writing Detroit

ist’s consolation, as intrinsically daft as believing bombs build good peace. Like anything else, it is what you make of it. In this way, all workers are artists, sworn to an ingenuity that they must create for themselves.” 3 I was thinking the same thing when I wrote in the introduction to Autopsy of an Engine, my collection of short fiction inspired by the Cadillac plant, “We were all fabricating more than painted hunks of steel that could go honk honk honk in that rich melodic Cadillac way and then hog up the highways, humming away like we used to on the lines. We were creating a unique world that only we were privy to, a complete mystery to non-factory humanity.” ell, the exigencies of production have changed and those old time bastions of auto assembly are pretty much gone from almost everywhere. So are those workers. Those who are left work side-by-side with robots that don’t write. We, who experienced the last days of the heyday of auto production, were witness to the development of community within the factory and to the community outside as the Arsenal of Democracy shifted back to auto after WWII. Even then auto production was crawling to its deathbed. But through the ’60s to ’80s, auto was still breathing heavy enough. Certainly that was the case during the 1967 rebellion and the Revolutionary Union Movements (RUM), two of the last major upsurges in the city. RUM references a series of factory strikes in 1968. These strikes shut production down at various facilities. So, for example, at Dodge Main the movement was called DRUM. At Eldon Gear and Axle it was called ELRUM. These strikes, primarily led by the League of Revolutionary Black Workers, of which General Baker was a founding member, primarily addressed the wage and job inequities between white and black workers. One lesson we can learn from the rise and fall of struggles in present-day Detroit is that the loss of factories represents a loss of power. Those writing creatively in Detroit do so in the throes of the breakdown of industrial life more radical than the elegiac slower passing of factories. We are now witnessing the transformation of methods of production so powerful that human labor becomes obsolete. The rise of homelessness continues unabated since the appearance of robots in the factories of the ’70s. The newest generation of robots have U N I V E R S I T Y

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thumbs dexterous enough to assemble cars alongside humans. 4 What will this mean for the Detroit work ethic? Then again, the problem is not the robots but who owns them. What if through the use of robots we were still able to feed and clothe ourselves and have housing? How about universal health care? No more war? What if we were able to apply the work ethic to making art, writing poems, making music, expanding culture, improving our relations with the earth and each other? What if we were to have the space to repetitively explore our artistic range, get heavy into it, loving the nameplate of mother earth?

Detroiters are in an identity crisis, already consigned to the dust bins of history. Make no mistake: while not everyone in the city worked in the factories, the factory work ethic permeates the D still. But our memory of it is fast fading, and that is the new world that the new artists emerging from this city must create for themselves. But that’s for the future. In the meantime, we have a lot of struggle ahead of us, and we’ve got to do it without the aid of those mammoth containers of sweaty, tough labor, the auto factories. We are sprinkled throughout the city and suburbs, walking a tightrope. Sometimes I want to just fling some mixture of abcs, hoping it will hit a mark and make a difference. These days I’m wielding my pen through teaching writing courses in the U-M Residential College, which includes the Semester in Detroit Program (SID) and Saturdays in a mini-course with U-M students and Detroit public high school students writing fiction. The mini-course, in collaboration with the Ford Department of the UAW, finds us searching for our stories about the city, about ourselves. Imagine that. This is healing and bringing the health and ethos of the city

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to the forefront, even though many of the Detroit students don’t realize they wear the Detroit mantle like warriors. One asked, “Why can’t nonunion cars park in the UAW-Ford Department lot?”Answer: because they are non-union. Yes, I gave that answer. Many of us from the old factory days identify with extinct animals, most often dinosaurs, especially in reference to health care, defined pension benefits, and the community we once knew. We were like family with each other in there. General Baker passed away in May 2014, perhaps the victim of foundry work. In his later years he continued to struggle on behalf of working people. He delighted in coming to share his vast knowledge of labor history with the students of SID. He was with us from the beginning, which is why we have now established a scholarship in his name for students wishing to enroll in SID. I often think of myself as the spirit of Martha, the last passenger pigeon. She died in the Cincinnati Zoo, September 1, 1914. They say that at one time passenger pigeons were the most plentiful birds in the world, until being hunted in droves for food. Maybe I feel like the spirit of Martha, passing through with air under my wings trying to deliver this message along to these young people in Detroit and on campus. I think General must have felt the same way. Mostly, I’m hoping to survive the hunt. < Born and raised in Detroit, Lolita Hernandez is the author of Making Callaloo in Detroit, a 2015 Michigan Notable Book, and Autopsy of an Engine and Other Stories from the Cadillac Plant, winner of a 2005 PEN Beyond Margins Award. She teaches in the U-M Residential College and U-M’s Semester in Detroit. For more on U-M’s Semester in Detroit, visit lsa.umich.edu/sid. Notes: 1. Thomas Maloney, Warren C. Whatley, “Making the Effort: The Contours of Racial Discrimination in Detroit’s Labor Market 1920-1940,” The Journal of Economic History, 55, 3 (Sept 1995), 465-493. 2. As told to General Baker by Cynthia Holland, President of UAW Local 7, which represents the Chrysler North Assembly. 3. Ben Hamper, “Introduction,” Working Words: Punching the Clock and Kicking Out the Jams, ed. M. L. Liebler (Coffee House Press, 2010). 4. http://robonaut.jsc.nasa.gov/default.asp

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Seeing Detroit

To plan for tomorrow’s city, today’s residents are documenting the “Cues to Care” they find within their communities.

garden blooming in front of an abandoned house. A makeshift park on a vacant lot. A woman who in the summer mows ten lawns a week—only one of them hers. Images of everyday life, yes. But to the residents of Detroit’s Brightmoor neighborhood, they’re also signs of care that give hope to people like Kathleen Hurd, a longtime Brightmoor resident who is working to contribute to its revitalization. Hurd recently joined 15 others in a project designed to illuminate instances of care in Detroit. The four-month project, “Cues to Care,” focused on two Detroit communities, one in eastside Detroit and the other in the Brightmoor area. School of Public Health alumna Natalie Sampson, PhD ’13, spearheaded the project as a postdoctoral student in collaboration with Joan Nassauer, a professor in the U-M School of Natural Resources and Environment, who developed the "Cues to Care" concept. The two worked with colleagues in law, urban planning, and public health, and with 16 Detroit residents. Sampson, an assistant professor at U-M Dearborn, says she and her U-M colleagues wanted to see if the information they’d gleaned through observational surveys would resonate with what Detroiters themselves thought about their city. So Sampson and her team turned to Photovoice, a process through which people photographically capture aspects of their community as they see it—often in response to negative or misconstrued depictions perpetuated by nonresidents. After completing workshops in photography techniques, safety, and ethical issues, the participants in “Cues to Care” set out to document examples of care in their neighborhoods.

“We wanted to look at how people care for vacant spaces, and to help others see how residents cultivate community and property,” Sampson explains. Participants ranged from a young couple who moved to the neighborhood last summer to longtime residents. “We just continue to have hope, passion, one house at a time, one block at a time, one neighborhood at a time,” said a participant.

Brightmoor (in green) is an area of roughly four square miles situated on Detroit’s northwest border.

Built in the early 1920s as a planned community of affordable homes for auto workers who migrated to Detroit from the South, Brightmoor has the leafy streets and meandering streams of a suburb. But by 2010, much of the once-thriving working-class neighborhood, like other parts of Detroit, was struggling. Today, residents are working to revive the community. Joanna Lehrman, a graduate student in SNRE who helped implement the project, says the images and stories that have emerged from the project underscore the impact humans have on their landscapes—especially landscapes in transition, like Detroit’s. On the following pages are some of Brightmoor’s stories.

This project was funded by the U-M Office of Research as an outgrowth of a project supported by MCubed, a campuswide program that fosters innovation and collaboration at U-M. Faculty affiliates of the project include Alicia Alvarez, law; Margaret Dewar, urban planning; Joan Nassauer, SNRE; and Amy Schulz, public health.

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Kathleen

“In 1994 my children and I—they were about 6 and 8 at the time—moved into the house with the weeds and decay, and we lived there for four years. We moved out of the area in 1997, and with my adult children and grandchildren we returned in 2013, and we moved into the newer home. From the ashes, a new horizon.”

Theresa

“It is peaceful, you know. We have joy, and we just continue to have hope, passion, one house at a time, one block at a time, one neighborhood at a time.”

Brenda “I got to say, man, ’bout to make me cry, it is really beautiful over here.”

Luis

“It’s amazing that this garage in the background was literally invisible before the brushes and overgrowth were cleared.”

David “Upon moving to the neighborhood, my wife, Sky, and I started seeing trash dumped all over the street and woods. We are surrounded by a beautiful thriving forest, filled with wildlife, from deer to beavers to sandhill cranes. The natural environment was one of our main attractions to this neighborhood, so it saddened us greatly to see such disregard for our home. We painted a sign, which we later installed, that we hoped would speak to potential dumpers in a positive, non-demanding way.”

Seeing Detroit

“We have joy, and we just continue to have hope, passion, one house at a time, one block at a time, one neighborhood at a time.”

Sky

“This chimney, this lone pillar of

determination, is the result of an angry arsonist. My dear friend owns this property. This chimney reminds me of her. She bought a house on the river to grow her family in. It was burnt down mere days later. She’s still here, planning on what to grow on her now empty lot and starting non-profits while tending to her chickens and raising her children. The chimney stands tall and proud, as she does. It doesn’t crumble at the difficulty of living.”

Cindy

“That’s the pocket park that we put in

on the northwest corner of Dolphin and Denher. Somebody had dumped a load of tires, so I had the volunteers plant them in a circle for the kids to be able to run and play and jump and sit, and if you look in the background, that’s the vacant house adjacent to the double lot there. We boarded up the side of it with the children’s artwork, and … we used blackboard paint so they can use sidewalk chalk and go to town. There’s a tire swing hung as well. I added one of those little red toddler swings, and somebody else put a slide in. That’s the way the pocket park started out—it’s what can be done when you get movin’ on it.” U N I V E R S I T Y

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BeingDetroit 24

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The World Health Organization defines a “healthy city” not as one that has achieved a particular health status, but as one that is conscious of its health and working to improve it. A healthy city is thus determined by process, not outcomes. by Jeff Mortimer

This 1903 view of downtown Detroit shows the recently completed Wayne County Building— today one of the nation’s finest surviving examples of Roman Baroque Revival architecture—at the junction of Cadillac Square and E. Randolph Street. Belle Isle is visible immediately beyond the county building, and foundries, power plants, and other industrial sites line the banks of the Detroit River.

So as we think about Detroit in the first years of the 21st century, it behooves us to reflect on the city’s 300-year history—and on how that history relates to human health and well-being. The following timeline highlights both the triumphs and trials of Michigan’s great riverfront city, a midwestern emblem of American imagination, drive, and resilience.

Being Detroit

National Archives

This map of Detroit from the early 1800s denotes the ribbon farms along the Detroit River, with the city’s present-day boundary shown in white. Inset: A statue of Cadillac appears on the facade of the BookCadillac Hotel, the tallest hotel in the world at the time of its opening in downtown Detroit in 1924.

The D: 300 Years and Counting In an area long inhabited by native people, the city of Detroit is established in 1701, when Antoine de la Mothe Cadillac, a French army officer, creates Fort Ponchartrain, the first European settlement in the area. Its site, bounded by Griswold and Larned Streets and the Civic Center, is now occupied by office towers. Cadillac invites natives in the area to join the settlement, facilitating both trade and security, but they are not permitted to live inside the compound. Many Detroit streets, like Dequindre and Beaubien, still bear the names of the first French farmers around Fort Ponchartrain. Those farmers bring the technique known as “ribbon farms” along with them—long, narrow strips of land, all with water access —and as the city grows, thoroughfares are often named for the farmers who formerly tilled the land they run through.

The University of Michigan is founded as the Catholepistemiad of Michigania in 1817, and conducts a primary school and classical academy in a building at Bates and Congress streets. The name is changed in 1821, but neither school is operating by 1827, and the university ceases to exist except as a legal entity until its move to Ann Arbor in 1837.

Bentley Historical Library

Origins

The building housing the Cathelopistemiad of Michigania in Detroit in the early 1820s.

Note: Text in red indicates general health- or medical-related items; blue text indicates SPH or U-M involvement in Detroit.

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Left: The Highland Park Ford Plant, ca. 1916 Below: A 1940s-era postcard showing an aerial view of Belle Isle

At 982 acres, Belle Isle is larger than New York’s Central Park and is the largest cityowned island park in the U.S., although it is managed as a state park by the Michigan Department of Natural Resources under the terms of a 30-year lease. Named in 1845 to honor Isabelle Cass, daughter of then-Governor Lewis Cass, today’s Belle Isle is home to an aquarium, conservatory, zoo, museum, and a municipal golf course, among other attractions.

Because it is generally the final stop before crossing the border, Detroit is one of the most exciting places on the Underground Railroad, a clandestine network that helps enslaved African Americans on their way to freedom in Canada from the 1820s until the end of the Civil War. A Detroiter named Seymour Finney, owner of the Finney Hotel in downtown Detroit, is an important Railroad “conductor,” and Detroit’s Second Baptist Church, Michigan’s first black congregation, is a vital “station,” housing an estimated 5,000 fugitives over 30 years.

In 1827, the Detroit Common Council appoints three doctors to look after the health of the city’s poor residents. A nascent Detroit Board of Health acts to stem a possible outbreak of smallpox in October 1831. Just northeast of downtown, today’s Greektown is first settled in the 1830s by German immigrants. When they begin moving into neighborhoods farther from downtown early in the 20th century, they are supplanted by Greeks. The restaurants, stores, and coffeehouses the Greeks establish remain when they move on, resulting in the largely commercial and entertainment district we know today, which includes the Greektown Casino. A farmers market opens at Cadillac Square in 1841 and moves to its present location, renamed Eastern Market, 50 years later. The largest historic public market district in the U.S., Eastern Market now covers 43 acres and is surrounded by a neighborhood brimming with restaurants, art galleries, street musicians, and retail of all kinds.

The “Gateway to Freedom” monument on Hart Plaza commemorates the Underground Railroad.

the Civil War, its bells tolled 29 times every November 10 from 1975 to 2006 to commemorate the lives lost in the sinking of the Edmund Fitzgerald. Since then, the church has broadened its memorial ceremony to honor symbolically the more than 1,000 lives lost on the Great Lakes.

The Mariners’ Church of Detroit, 170 E. Jefferson Ave., is founded in 1842 as a special nondenominational mission to maritime travelers on the Great Lakes. A stop on the Underground Railroad before

Mid-Century Growth The first official Michigan State Fair takes place in 1849, and a 167-acre site east of Woodward Avenue between 7 ½ and 8 Mile Roads becomes its permanent home in 1905. Attendance peaks at 1.2 million in 1966 but is only 217,000 in 2009, the last year the fair is held in Detroit. The grounds now belong to the Michigan Land Bank Fast Track Authority, which will oversee future development there.

Mariners’ Church Detroit News Archives

Early Arrivals

Vernors Ginger Ale, created by Detroit pharmacist James Vernor, is first served to the public in 1866. Wayne State University, originally called Detroit Medical College, is founded in 1868.

Eastern Market in the early 1900s

Below: the Edmund Fitzgerald

Being Detroit

During the 1870s, the Parke-Davis and Company pharmaceutical plant, including the first pharmaceutical research laboratory building in the U.S., moves to the Detroit riverfront, below.

Major league baseball is played at the corner of Michigan Avenue and Trumbull Street from 1895, when Bennett Park opens, until 1999, when Tiger Stadium (formerly Navin Field and Briggs Stadium) is host to the final contest in its history. The park

Diego Rivera’s mural on the north wall of the DIA Grand Court depicts laborers working at Ford Motor Company’s River Rouge Plant. Navin Field in the early 1930s

Epidemiologist Henry Frieze Vaughan, eventual dean of U-M SPH (1941–1960), joins the Detroit Department of Health in 1914. He serves as Detroit’s health commissioner from 1919 to 1941.

The Auto Age At over 120 acres, the Highland Park Ford Plant is the largest manufacturing facility in the world when it opens in 1910. In 1913, it becomes the first automobile production facility in the world to implement the assembly line, lowering the production time for a Model T by almost 90 percent and its price by half. Ford offers nearly three times the wages paid at other unskilled manufacturing plants.

Detroit Historical Museum

The Detroit Institute of Arts is founded in 1885 and moves to its current site, at 5200 Woodward Ave., in 1927. Its collection is among the top six in the U.S. Its most famous feature, the Diego Rivera mural in the Grand Court, is considered by the artist to be his finest work. The DIA and its neighbors, the Detroit Historical Museum, Detroit Public Library, Michigan Science Center, Charles Wright Museum of African-American History, and Wayne State University campus, are now the core of the city’s Cultural Center Historic District.

Detroit Institute of Arts / Bridgeman Images

is demolished 10 years later. The Corktown neighborhood surrounding the stadium is the city’s oldest, tracing its origins to the huge influx of Irish, most of them from County Cork, in the wake of the Great Irish Potato Famine of the 1840s.

Funded and built by its namesake, Henry Ford Hospital opens in 1915 on Hamilton at West Grand Boulevard, with room for 48 patients. Today’s Henry Ford Health System maintains 30 medical centers, including the original Henry Ford Hospital, and is the state’s fifth-largest employer.

Dr. James W. Ames (front row, second from left) and the staff of Dunbar Memorial Hospital in 1922

Established in 1917 by Drs. Davis and Daisy Northcross, the 20-bed Mercy General Hospital is the first African-Americanowned and operated hospital in Detroit.

With the aim of creating a nonprofit institution to serve Detroit’s African-American population, Dr. James W. Ames and others establish Dunbar Memorial Hospital in 1917.

To provide more space for Detroit’s sick poor, the city’s Board of Poor Commissioners constructs the first unit of the Detroit Receiving Hospital in 1913. Designed by the same architects responsible for New York’s Grand Central Station, the Michigan Central Station, 2405 West Vernor Highway, opens on January 4, 1914, and closes 74 years and two days later with the cessation of Amtrak service. The tallest railway station in the world at the time of its construction, it has stood vacant and decaying for 27 years, best known now as a favorite subject of so-called “ruin porn.”

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Shown here, active community partners of the Detroit Community–Academic Urban Research Center and affiliated partnerships Data Driven Detroit

Mercy Primary Care Center Green Door Initiative Friends of Parkside

Neighborhood Service Organization

Alkebu-lan Village Detroit Future City Arab American Community Center for Economic and Social Services (in Dearborn)

Detroiters Working for Environmental Justice

Henry Ford Health System Wayne State University Law Clinic

Detroit Eastside Community Collaborative Eastside Community Network

Communities In Schools

Sierra Club Covenant Community Care Southwest Detroit Environmental Vision

A Detroit Urban League Clinic nurse examines a patient in 1945. In 1919, in response to the influenza pandemic, the Detroit Urban League opens its baby clinic within the Columbia Community Center to treat the underserved African-American population. For many clients, this is their first contact with professional health services. Famed for the “Wild Beast,” a wooden roller coaster, and its 110-foot Ferris wheel, Edgewater Park, at Grand River Avenue and Seven Mile Road, provides inexpensive entertainment for Detroit’s working classes from its opening in 1927 until 1981, particularly during the Great Depression and World War II. Greater Grace Temple now occupies the 20-acre site.

Institute for Population Health

Latino Family Services Community Health and Social Services Center

The Detroit Zoo has been located at Woodward Avenue and 10 Mile Road in Royal Oak, two miles north of the city limits, since 1928. The first zoo in the U.S. to use barless exhibits exclusively, it welcomes more than 1.1 million visitors annually to its 125 acres of exhibits, where more than 3,300 animals representing 280 species live.

Designed by Albert Kahn and completed in 1928, Ford’s Rouge Plant is for decades where raw materials from all over the world are turned into cars—the greatest example of vertically integrated manufacturing ever seen. More than 100,000 people work here in the 1930s. The site is now home to Ford’s Rouge Center, an industrial park that includes a sustainably designed truck factory.

When completed in 1929, the Ambassador Bridge between Detroit and Windsor, Ontario, is the longest suspended central span in the world. Today more than 25 percent of all trade between the U.S. and Canada crosses the bridge, which on a typical weekday carries more than 10,000 commercial vehicles. A new bridge further downriver has been approved for construction by the Canadian and U.S. governments.

New York Times

Bentley Historical Library

Between October 1 and November 20, 1918, a total of 18,066 cases of influenza are reported to Detroit’s Department of Health. Another 10,920 cases come in early 1919, when the disease makes a significant comeback.

Detroit Hispanic Development Corporation

Hamtramck Stadium, 3201 Dan St., is home to several Detroit Negro League baseball teams in the 1930s and is listed on the National Register of Historic Places. It’s one of only five remaining Negro League ballparks, and at least 17 members of the National Baseball Hall of Fame play here.

The Detroit Stars at Hamtramck Stadium, ca. 1930 When typhoid strikes Ringling Brothers and Barnum and Bailey Circus while playing Detroit in 1934, Don W. Gudakunst, the city’s deputy health commissioner and a non-resident professor of public health at U-M, investigates. The circus subsequently institutes new measures to protect the health of both employees and the public. Black Bottom, a predominantly black neighborhood on the Near East Side, becomes known for its contribution to American music from the 1930s to the 1950s. Stars such as Duke Ellington, Pearl Bailey, Ella Fitzgerald, and Count Basie regularly perform in its bars and clubs. In the early 1960s, the city razes the entire Black Bottom district and replaces it with the Chrysler Freeway and Lafayette Park.

Being Detroit

Motown founder Berry Gordy Jr. In continuous operation since 1940, the Detroit Wastewater Treatment Plant services almost 1,000 square miles of the state of Michigan, encompassing 35 percent of its population. It is the largest facility of its kind in the U.S. Mexicans begin settling southwest of Corktown, in what is now known as Mexicantown, in the 1940s. Known for its abundance of restaurants and brightly decorated buildings, its main thoroughfares are Bagley (the community is originally known as “La Bagley”) and Vernor streets.

The Ford F-150 Plant, which opens in 2004 on the original Rouge plant site, uses special paint on its vehicles, employs strict emission controls, and features a “green roof” planted in grass and other vegetation.

In the early 1970s, U-M SPH Professor Sy Axelrod works with the UAW to promote the establishment of health maintenance organizations. Conceived by Henry Ford II and financed primarily by the Ford Motor Company, the Renaissance Center is intended to revitalize the economy of Detroit. The first phase, comprising four 39-story office towers surrounding a 73-story hotel (still the thirdtallest all-hotel skyscraper in the Western Hemisphere), opens in 1977.

In 1948, control of the Detroit Receiving Hospital; its branch, the Redford Receiving Hospital; and the City Physician’s Office is transferred from the Welfare Department to the Health Department. Held at U-M SPH, the first Selby Discussional, in 1950, brings together medical directors, teachers, consultants, industry leaders, and researchers—among them U-M SPH faculty member Clarence Selby, former medical director of Detroit-based General Motors—to discuss industrial and occupational health.

Motown and Beyond Detroit’s Motown record label issues its first release in 1959. Tens of thousands of visitors a year now pass through Hitsville, U.S.A., home of the Motown Museum, at 2648 W. Grand Blvd.

In 1985, the Detroit Medical Center is organized as a union among Harper University Hospital, Grace Hospital, Hutzel Women’s Hospital, and Children’s Hospital of Michigan. With the addition of other hospitals, the campus of DMC and its adjacent partner institutions now takes up most of the area bounded by Mack Avenue, Warren Avenue, John R., and Beaubien.

In 1991, the U-M Air Quality Laboratory undertakes the first of a series of studies of atmospheric mercury in the Great Lakes region. The Detroit Community–Academic Urban Research Center is founded in 1995. A partnership involving three U-M units, including SPH, and ten community-based organizations, the Detroit URC aims to eliminate health inequities in Detroit. Starting in 1998, community partners and SPH researchers launch the Michigan Center for the Environment and Children’s Health, to conduct assessments of children with asthma in Detroit and to develop initiatives to improve indoor air quality and asthma-related health.

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In 1998, the East Side Community Health Insurance Program for Children, an SPHled coalition, begins enrolling eligible children of the working poor on Detroit’s east side into MIChild, which provides them with regular checkups, dental and vision care, and other basic medical services.

In the mid-1980s, U-M SPH Professor Noreen Clark tests the Open Airways asthma self-management program in the Detroit Public Schools. Results show marked success in significantly reducing asthma symptoms and health-care use and in improving school performance.

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Through a 2005 project funded by the National Institute of Environmental Health Sciences, SPH Professor Jerome Nriagu and others raise environmental health awareness and reduce the impact of environmental exposures among Arab Americans in Metro Detroit.

Stretching from Joe Louis Arena to Belle Isle, the Detroit RiverWalk, which opens in 2007, offers breathtaking views of the Detroit and Windsor skylines, as well as pavilions, fishing piers and benches.

The Detroit Incinerator, opened in 1986, is the target of repeated complaints about its odor and suspected public health problems. Grassroots organizations such as Zero Waste Detroit, with assistance from U-M SPH, fight with some success for tougher regulation of the plant.

In the early hours of Sunday, July 23, 1967, Detroit police officers raid a “blind pig,” or unlicensed drinking club, at 9125 12th Street (now Rosa Parks Boulevard), triggering five days of violence and arson that leave 44 people dead and cause $50 million in property damage.

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In 2005, U-M SPH alumnus and Professor Gail Warden, President Emeritus of Henry Ford Health System, helps launch the Detroit Wayne County Health Authority, aimed at meeting the health needs of uninsured and underinsured residents of Detroit and Wayne County.

In 2012, Detroit and Flint public schools introduce a genomics curriculum for high school biology classes developed jointly by U-M SPH and the U-M School of Education. By 2013, after undergoing a recent $2.2 billion expansion, the 250-acre Marathon Refinery, first built in 1930 by the Aurora Gasoline Company, is one of the most controversial sites in the city. < Jeff Mortimer is a freelance writer and editor in Ann Arbor.

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by Leslie Stainton

Portrait photos by Rebecca Minch

Leading Detroit A new generation—young, smart, and above all compassionate— steps up to the plate.

early every day in Detroit, someone gets an unexpected diagnosis. The words may vary, but the impact doesn’t. You have HIV. Much of the time, the person hearing those words is a young man or transgender individual, often a teenager, who may not know where to turn. It’s one thing to talk in abstract terms about the high rates of sexually transmitted infections among young men who have sex with men— a population more gravely affected by STIs, including HIV, than any other in the country, and certainly in Michigan. It’s another to imagine being young and vulnerable, and learning you have HIV, and feeling you can’t confide in anyone because you’re terrified of being judged, but at the same time having no idea where to go for treatment or how to keep from spreading the virus or how to survive into your twenties, let alone the rest of adulthood. That’s why a new project, funded by the U.S. Centers for Disease Control and Prevention and aimed at lowering the spread of HIV and other STIs in southeast Michigan (see sidebar, page 33), has recruited six young members of the region’s LGBT community to serve as its Youth Advisory Board. They remind academic researchers and community partners what it’s like to be young. They help point out where, when, and how to intervene. By definition, says Emily Pingel, MPH ’09, project director of U-M’s SexLab, the admin-

istrative home for the project, the Youth Advisory Board is “like the White House. They have veto power over the decision-making of the whole coalition.” Following are snapshots of three board members—all in their early twenties, all native Detroiters. Like the city where they live and grew up, they’ve faced adversity and are resilient. They’re also passionate about creating change, both in the city they love and within the LGBT community they call home. The CDC has one name for the project: “Community Approaches to Reducing STIs.” But the Youth Advisory Board has another: “Michigan Forward in Enhancing Research and Community Equity,” or “MFierce.” The name says as much about the board as it does about the project.

Curtis Collins

By his own reckoning, Curtis Collins, 24, was a rebellious child. He wasn’t angry at anyone—“I just wanted to do things my own way, ’til I learned the hard way.” He flashes a bright smile. By the time he was 16, he’d joined Detroit’s LGBT community and was hanging out at Palmer Park, a public space designed in the late 1800s by Frederick Law Olmsted, near Six Mile and Woodward. He saw others having fun, Curtis says, and he wanted “to see what this lifestyle is about.” Palmer Park was the center for “everything,” he adds. He made friends there, and for a time even lived at the park. In summertime it was

Leading Detroit

“the hangout spot. Everybody parked their cars out there, do drinks, whatever, just have fun. But it wasn’t just us over there.” Commercial sex workers worked the alleys around the park. It was often dangerous, “real dangerous.” One night Curtis watched a friend go off in the woods with a man to “make a little money.” He waited for his friend to come back so they could go for a drink, but his friend didn’t show. Then Curtis heard a strange voice. Suddenly his friend staggered onto the street and collapsed. “It was like blood coming from everywhere,” Curtis remembers, “like someone just maliciously hit him with some type of metal pole.” Curtis phoned 911, but his friend never regained consciousness and died later that evening. At 6’5”, Curtis knows how to defend himself, and he’s not afraid. It’s part of the street smarts that make him who he is—and make him invaluable to MFierce. Thanks to what he calls his “street-cred experience,” Curtis is able to take MFierce’s academic partners “behind the scenes,” as he puts it, “and show them where and how things happen in Detroit, how people from the LGBT community live their life, what they gotta do to make their ends meet.” He describes it as giving researchers “the rated-R version more so than the rated-G version.” The “ratedG version” is what goes into a published paper, he explains. “But you need the rated-R if you’re going to make a difference.” He’s known that he’s gay as long as he can remember. Unlike a lot of young men his age, he’s never had problems at home. His mother, with whom until recently he shared a house in downtown Detroit, doesn’t care how he lives his life, as long as he goes to school and does what he’s “supposed to do,” meaning be a good and productive citizen. Curtis graduated from high school in 2010 and currently holds down two jobs in the hospitality industry. “The only person I’m scared of,” he says with a grin, “is my mama … and God himself.” MFierce allows him to be of service to both the academic and the LGBT communities, and Curtis is grateful. He’s especially keen to help young men with HIV cope by putting them in touch with resources and reminding them that HIV is not a death sentence. He’s one of a handful of people, he says, “that don’t mind being that extra ear or extra voice to help you get through whatever you gotta get through.”

The “rated-G version” is what goes into a published paper, Curtis explains. “But you need the rated-R if you’re going to make a difference.”

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D’Angelo Kea

Telling his father he had HIV was bad enough. But telling his new boyfriend was worse. “I was so terrified … so terrified,” remembers D’Angelo Kea. He could scarcely bring himself to speak. The diagnosis had revived his deepest fears—who would love him now? At 18, D’Angelo couldn’t imagine. But when he finally mustered the courage to speak, his boyfriend of a few weeks, Dasean Walters, didn’t seem worried. “Live your life,” Dasean told D’Angelo. “Stay healthy. You’re not going to die from this.” And then he said the words D’Angelo had despaired of hearing: “I’m still here. I’m not going to leave you, if that’s what you’re thinking.” Today, D’Angelo, 25, and Dasean, 26, are engaged to be married. For D’Angelo, being gay isn’t an issue. He knew from the time he was a kid that he was attracted to men. His parents have each been in gay relationships for years. They split when D’Angelo was five, but they remain close. When he went to Henry Ford’s HIV clinic to learn about treatment options after his diagnosis, his mother and father both went with him. The three of them wept together. D’Angelo knows that, relatively speaking, he’s lucky. He’s able to control his HIV with medications. As a member of the Youth Advisory Board for MFierce, he’s employed by the University of Michigan. He’s got loving parents and a doting fiancé who reminds him to take care of himself and encourages him to pursue his dream of becoming a video-game developer, and maybe using those same skills in the health field. There are plenty of young Detroit kids who are struggling with their sexual identity but who have no support system, and D’Angelo wants to help them. Maybe their parents have kicked them out. Maybe they’ve got an STI, but they’re too afraid to tell anyone for fear of being rejected. Maybe they just don’t know where to turn. D’Angelo hopes he can show them “a brighter side.” By sharing his own story with Detroit’s LGBT community, and by serving on the MFierce advisory board, where he contributes to decisions about new HIV and STI prevention and treatment strategies, he hopes to “make an impact in the world” and help the gay community. Perhaps he can even help someone younger “prevent getting HIV.” For the first time in his life, he says, “I feel comfortable in my own skin.”

When D’Angelo went to Henry Ford’s HIV clinic to learn about treatment options after his diagnosis, his mother and father both went with him. The three of them wept together.

Leading Detroit

A Comprehensive, Efficient, and Culturally Sensitive Approach A new CDC project aims to reduce sexually transmitted infections among young men in southeast Michigan.

hen the once-booming American auto industry collapsed in the last decades of the 20th century, southeast Michigan took a huge economic hit—especially in the vast, racially diverse metropolitan areas of Flint and Detroit. Health outcomes and behaviors in the region took a second hit, with unprecedented increases in conditions such as obesity, violence, and sexually transmitted infections (STIs), including HIV. Today the state of Michigan has the nation’s seventh highest cumulative gonorrhea infection rates and 14th highest cumulative chlamydia infection rates, according to the U.S. Centers for Disease Control and Prevention. The devastating impact of these infections is most keenly felt in the Detroit and Flint metro areas among young men who have sex with men—a population that also suffers disproportionate rates of HIV. When stratified by race and ethnicity, it’s clear that within this group, young black and Latino men who have sex with men bear the brunt of Michigan’s STIs. How to reduce these disparities? Jose Bauermeister, the John G. Searle Assistant Professor of Health Behavior and Health Education at the School of Public Health, thinks the solution lies in a communitybased approach focused on structural factors. “We know that these disparities are forcibly molded by dominant structural forces like racism, economic disadvantage, residential segregation, and homophobia,” says Bauermeister, who directs the U-M Center for Sexuality & Health Disparities (SexLab). “And we know that those same forces limit the development of safe spaces where young gay, bisexual, and other men who have sex with men and transgender people can express their sexuality and gender, and find both the support and opportunities they need.” Bauermeister is lead scientist for a new three-year, one-million dollar project, “Community Approaches to Reducing STIs”—or “MFierce,” as the project’s six-member Youth Advisory Board has dubbed it—aimed at reducing STIs among young gay and bisexual men and transgender women in southeast Michigan. Launched in Detroit last fall in partnership with community members and organizations throughout the region, the CDC-funded project supports the planning, implementation, and evaluation of interdisciplinary interventions aimed at both the treatment and prevention of STIs. “If we can improve one area of the system, it has the potential to ripple throughout and spark much needed community mobilization and change,” Bauermeister says. He and his fellow researchers and community partners have spent the first year of the project working to heighten awareness of the problem as it affects young men and transgender women, to identify new avenues for STI prevention and treatment within this population, and to provide greater access to culturally sensitive services. Bauermeister and his colleagues plan to devote years two and three of the project to the implementation and evaluation of strategies for reducing STI disparities. Ideally, their work will prove effective enough to be adopted nationwide. <

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Partners for Health Collaboration is critical to the success of MFierce, the new CDC-funded academiccommunity partnership aimed at reducing disparities in sexually transmitted infections in southeast Michigan. Here’s a list of partner organizations: Affirmations ACCESS AIDS Partnership Michigan Community Health Awareness Group Connect to Protect Corner Health Detroit Central City Health Center Detroit Department of Health and Wellness Promotion Genesee County Health Department HIV/AIDS Resource Center The Horizons Project, Wayne State University KICK (The Agency for LGBT African Americans) Michigan AIDS Coalition Michigan Department of Community Health Michigan Organization on Adolescent Sexual Health Planned Parenthood Detroit Planned Parenthood of Southeast Michigan Ruth Ellis Center SexLab, University of Michigan Teen Hype University of Michigan Health System University of Michigan Hospital Systems Community Programs and Services University of Michigan School of Public Health Washtenaw County Public Health Department Wayne State University School of Medicine Wellness Services

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Ghosts of Tuskegee

unding for the new U-M SexLab project, “Community Approaches to Reducing STIs,” or “MFierce,” comes from the CDC Office of Minority Health and Health Equity, which administers reparation funds from the Tuskegee Study of Untreated Syphilis in the Negro Male. The notorious study took place between 1932 and 1972 under the auspices of the U.S. Public Health Service (PHS) and involved 600 AfricanAmerican men—two-thirds of whom had syphilis. All trial participants were the sons and grandsons of slaves; few had ever been seen by a doctor. Although penicillin became the standard treatment for syphilis in 1947, researchers withheld medication from the men in order to track the natural progression of untreated syphilis over the course of the 40-year study. The project came to an end in 1972, when a former PHS investigator exposed the study’s unethical methods. Subsequent Congressional hearings led to strengthened federal guidelines to protect human participants in research studies. As part of a 1974 legal settlement with the study participants and their families, the U.S. government established the Tuskegee Health Benefit Program, which today provides lifetime medical and health benefits and burial services to all living participants, their wives, widows, and offspring. The CDC administers the program. In 1997, then-President Bill Clinton issued a formal apology for the Tuskegee study on behalf of the nation. Five of the study’s sole survivors, all of them over age 85, attended the White House ceremony. “The United States government did something that was wrong, deeply, profoundly, morally wrong,” Clinton told them. “To the survivors, to the wives and family members, the children and the grandchildren, I say what you know: no power on earth can give you back the lives lost, the pain suffered, the years of internal torment and anguish. What was done cannot be undone. But we can end the silence.” < For more visit cdc.gov/tuskegee/timeline.htm.

More than anything, Dasean wants to help others find the love and support that eluded him for so much of his young life.

Leading Detroit

Dasean Walters

When his adoptive mother found out Dasean Walters was gay, she didn’t like it. A deeply religious woman, she’d worked hard to shield Dasean from “everything,” he says. She wouldn’t let him have friends over, or ride his bike, or go on sleepovers. “I hated feeling closed in,” he remembers. So he ran away. He kept running away, “getting in trouble.” He went to Minnesota and Atlanta. He spent a year and a half in Wayne County’s juvenile jail “for doing stuff.” After he got out, he went into therapy, but when he learned his adoptive mother still didn’t want him back, he got angry. And hurt. Shuffled into foster care as a young child, deprived of siblings and friends, Dasean wrestled with what he calls his “attachment issues.” Would anyone ever accept him? As a kid he’d hated gays. Even though he had inklings that he “liked boys,” he’d repressed those feelings and instead “beat up on gay people. I used to bash them and talk about them bad. I was like, ‘You fag.’” It wasn’t until years later, living in Detroit as a young adult, that Dasean realized who he really was. Now 26, he’s devoting his life to helping other young men accept themselves and their sexuality—and find the resources they need to live positive, fulfilling, healthy lives. As a member of MFierce’s Youth Advisory Board and a former volunteer for several community organizations, including AIDS Partnership Michigan and Detroit’s Ruth Ellis Center, Dasean knows he can make a difference in young lives. “I’ve always wanted to help people … always wanted to help people,” he says. But it was the health status of his fiancé, D’Angelo Kea, that pushed Dasean into the field of HIV prevention. Not long after D’Angelo’s diagnosis in 2009, Dasean enrolled in a program to become a certified HIV test counselor. Some day he hopes to open his own clinic and youth program in Detroit. “We don’t have a lot of those here—especially free clinics or safe-space programs that focus on the individual’s needs.” Being affiliated with MFierce is a “gamechanger,” Dasean says. “When I tell people, hey, I work for the University of Michigan, it’s, like, they have a different respect.” As a Youth Advisory Board member, he relishes the very real power he has to offer ideas and opinions and to vote “yea or nay” on plans. “We can go

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far with this,” he says of himself and his fellow board members. At his most ambitious, Dasean dreams of being “the mayor of a city, or a United States ambassador, or Secretary of State, or President. I always see myself as a leader.” But for now he’s happy being “an ambassador for young LGBT individuals and couples.” More than anything, he wants to help others find the love and support that eluded him for so much of his young life. He also relishes his role in helping Detroit grow. “The city is slowly but surely opening up itself to LGBT individuals,” he says, “and so taking a part in this great project, in this great initiative, it’s helping me guide the city to a more open policy.” And that makes Dasean Walters very happy. <

Online Resources

ith a two-year, $250,000 grant from the Herb Ritts Foundation, U-M’s SexLab is developing an online intervention that helps young gay and bisexual men and transgender women navigate health and social services resources in southeast Michigan. The project, iCON, is designed “to empower young gay or bisexual men and transgender women to be able to make positive changes in their life by identifying and setting goals for service use through a web app,” say Jose Bauermeister and U-M Professor of Nursing Rob Stephenson, co-directors of SexLab. If the web app is successful, Bauermeister and Stephenson hope to expand its reach nationwide. The Herb Ritts Foundation supports organizations advocating continued awareness, prevention, care, and research of HIV/AIDS.

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U-M sph in Detroit The Detroit URC celebrates 20 years of equitable partnership

aunched in 1995 with core funding from the U.S. Centers for Disease Control and Prevention, the Detroit Community– Academic Urban Research Center (Detroit URC) celebrates its 20th anniversary this year. An equitable partnership among communitybased organizations, public health and health care institutions, and academic researchers from U-M, the Detroit URC initially focused on child and family health issues, identifying several priority areas. The center has since expanded its mission, says director Barbara Israel, professor of health behavior and health education at U-M SPH, and now aims, above all, to foster and support collaborative research partnerships that examine and address the social and physical-environmental determinants of health, with the goal of eliminating health inequities in Detroit.

Key to that effort is the prevention and management of chronic disease, particularly cardiovascular disease, diabetes, and childhood asthma. “That means a lot of emphasis on, for example, air pollution, the built environment, social support, social cohesion, and access to food and places to be physically

active,” says Israel, noting that three of the center’s oldest and best-known affiliated partnerships are Community Action Against Asthma, REACH Detroit, and the Healthy Environments Partnership. “We’re always asking ourselves, ‘What in the community facilitates health?’” At the outset, Israel and her partners in the Detroit URC spent the better part of two years hammering out the community-based participatory research principles and operating norms that would underlie their collaboration. After a year and a half of dialogue, she says, “I felt the Detroit URC would work. I didn’t know that it would work for 20 years!” As noted by its Detroit-based partners, the Detroit URC has deepened bonds and strengthened communication among the city’s diverse communities—especially between African Americans and Latinos—and between Detroiters and U-M. And the center has been associated with such new initiatives as Detroit Future City, a strategic citywide initiative aimed at stabilizing and improving Detroit, and the Detroit Environmental Agenda, which identifies and addresses environmental issues in the city. Going forward, Israel and her colleagues hope to expand the Detroit URC’s collaborative research, in part by fostering and mentoring new partnerships and by engaging additional researchers from Michigan State University, Wayne State University, and U-M, as well as new community organizations. In the last year, the center has received funding from the W.K. Kellogg Foundation and the National Institute on Minority Health and Health Disparities to help support these efforts. The center has also received grants from the National Institute on Health Care Reform.

Jason Mrachina

On the Ground

“That means a lot of emphasis on air pollution, the built environment, social support, social cohesion, and access to food and places to be physically active.”

Israel is quick to credit the center’s success to its community partners and their “incredible commitment and dedication in the face of multiple challenges. What’s been really powerful, and what has enabled us to move through the 20 years of all these other contextual issues happening in the city, is their steadfastness to keep pushing on and making change.”

W For a video on the Healthy Environments Partnership “Walk Your Heart to Health” program, see sph.umich.edu/findings/. <

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U-M sph in Detroit Collaborative efforts to reduce the health impacts of air pollution

In the Air

ir pollution affects any number of American cities, Detroit included, but what interests Tim Dvonch most are the factors that set Detroit apart from the rest of the country. Those include industry, notably automobile manufacturing and associated iron and steel production, as well as a large oil refinery, sizable coal-fired power plants, and significant traffic—including the largest commercial border crossing between the U.S. and Canada. To assess the health impacts of emissions from these sites, Dvonch, an associate professor of environmental health sciences at SPH and director of the U-M Air Quality Lab, is conducting a series of studies, some with partnerships affiliated with the Detroit Community–Academic Urban Research Center (Detroit URC). In collaboration with researchers in Community Action Against Asthma, for example, he has examined the role of air pollutants in childhood asthma. Dvonch is also working with SPH Professor Amy Schulz and the Healthy

Major Detroit URC achievements during the past two decades include:

► Employment, both part- and full-time, as well as training for over 400 Detroit residents. ► The establishment of over ten community-based participatory research partnerships that have been funded for over 35 etiologic research and intervention projects.

► Policy-advocacy training for over 500 Detroit residents, many of whom have gone on to engage successfully in policychange efforts.

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Environments Partnership to understand how air pollution exposures contribute to risk for cardiovascular disease. To date they’ve found that exposures appear to have a stronger effect in communities nearest emission sources. Dvonch is also involved in GLACIER (the Great Lakes Air Center for Integrated Environmental Research), one of four national Clean Air Research Centers funded by the U.S. Environmental Protection Agency. GLACIER is charged with assessing the role of airborne pollutants in cardiometabolic syndrome across both urban and rural airsheds. Using mobile exposure laboratories, Dvonch and a team of researchers from U-M, Michigan State University, and Ohio State University are assessing the impacts of air pollution exposures in specific Detroit-area communities. The team employs both animal models of exposure and human exposure studies in an effort to identify the mechanistic processes by which specific airborne pollutants contribute to disease. They’re also comparing

Through Community Action Against Asthma and the Healthy Environments Partnership, he and his colleagues have shared their findings with both community members and policymakers at the local, state, and federal levels. “We would like to think our work has informed and improved regulations,” Dvonch adds. <

► Significant contributions to the scien-

► The development and implementation of

tific understanding of social determinants of health and health inequities, including the publication of over 185 peer-reviewed articles and over 350 presentations at national meetings.

interventions benefiting more than 3,000 Detroit residents, including a communityhealth worker intervention that reduced asthma symptoms among children and depressive symptoms among parents of children with asthma, and a walking-group intervention that reduced a number of risk factors for cardiovascular disease.

health master’s and doctoral students and postdoctoral fellows.

funding for the Healthy Environments Partnership, REACH Detroit, and Community Action Against Asthma.

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To date they’ve found that air pollution exposures appear to have a stronger effect in communities nearest emission sources.

► Training for more than 600 public

► $40 million in research grants, including

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the effect of these pollutants on health in Detroit with their impact outside the city. “We see clear impacts from local urban emission sources, which means this can be regulated, and that’s important for informing policy- and decisionmakers,” Dvonch says.

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► Global recognition as the “gold standard” for conducting community-based participatory research.

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researchDigest A Call for Greater Flexibility in High- Deductible Plans In a March 11 post on the new Health Affairs Blog, researchers in the U-M Center for Value-Based Insurance Design addressed the complexities of some of the nation’s fastest-growing health plans—health savings account–eligible highdeductible health insurance plans (HSA-HDHPS). Specifically, the authors, including V-BID Director and U-M SPH Professor Mark Fendrick, called for increased flexibility for coverage for high-value services, such as those used in chronic-disease management. Currently, HSA-HDHPS require the deductible to be met before such coverage begins.

by Nora White

Detroit’s Chronic Disease Challenge

ore than half of the world’s population lives with at least one chronic condition. In places like Detroit, chronic diseases such as asthma and type 2 diabetes, which disproportionately affect urban minorities of lower socioeconomic status, pose a particular challenge. One way to confront this challenge is to improve people’s lifestyle behaviors and support their efforts to self-manage chronic conditions after diagnosis. Scientists in the U-M Center for Managing Chronic Disease (CMCD) are working to do just that—improve chronic-illness care by supporting people with, and at risk for, diabetes and other conditions. By better understanding the social, behavioral, environmental, and clinical factors that underpin chronic disease, researchers hope to facilitate behavioral changes that can improve health outcomes, increase quality of life, and decrease costly health-service use—around the world and here at home, in Detroit. For more visit cmcd.sph.umich. edu/.

Noting that high-deductible plans must provide certain preventive services at no cost to asymptomatic patients, V-BID researchers say it’s inconsistent with clinical guidelines, cost-ineffective in the long run, and potentially harmful to patients to impose cost barriers to evidenced-based services to treat existing conditions, such as diabetes, mental illness, HIV, or cancer. “While we agree that there is value in evidencebased preventive services for asymptomatic people,” the researchers wrote, “we feel it is important to recognize that the prevailing focus on primary prevention tilts the system against services often of much greater value: those that prevent adverse consequences associated with diagnosed disease.” The V-BID blog post is part of a larger initiative to modify Internal Revenue Service guidelines to allow HSA-HDHPs greater flexibility in plan design, so that ultimately consumer engagement is enhanced, quality of care improved, and health care costs lowered. <

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Asthma Older adults with asthma are often overlooked by researchers focused on the epidemic of asthma among children and adolescents. To address this issue, lead investigator and SPH Assistant Professor Alan Baptist and his team are studying the effects of an asthma self-management intervention to help adults over age 40 prevent acute, and possibly life-threatening, episodes. Under the direction of Randy Brown, director of asthma programs, a CMCD team is wrapping up two asthma clinical trials: Women Breathe Free, a study to test the efficacy of a telephone-based asthma self-management intervention for African-American women; and PACE Plus, a study to determine whether a physician-training program based on cultural competency improves asthma management and symptoms in low-income African-American and Latino children.

includes a family-caregiver program.

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Diabetes CMCD researcher Laurie Lachance is partnering with the National Kidney Foundation of Michigan to evaluate programs aimed at reducing diabetes-related disparities in vulnerable communities in northwest Detroit. Her research team is tracking efforts to change local policy and infrastructure, interviewing key informants, and assessing the impact of local coalitions. Developed by CMCD Director John Piette, the CarePartner program is designed to test the effectiveness of a year-long automated telemonitoring intervention, which provides weekly updates to participants on their diabetes status and self-management efforts. The intervention

One of eight nationwide sites funded by a Safety-Net Enhancement Initiative (SNEI) grant from the Kresge Foundation, IMPACT, a Healthy Living Campus located in Detroit’s St. John Conner Creek Village, aims to reduce diabetes and hypertension by providing a safe, central

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location for services and activities. Laurie Lachance is leading efforts to evaluate the initiative, which supports community-based projects to address the social determinants of health. To date, the Detroit SNEI has worked to transform physical infrastructure, create system and organizational changes, and develop a social network around health.

► Mental Health

Health Disparities In collaboration with the Kellogg Foundation’s Food & Fitness community partnerships, which seek to inform communities about tangible improvements to food access, Laurie Lachance and her research team are partnering with Detroit communities to assess the efficacy of local

Spearheaded by CMCD Director John Piette, the Peer-to-Peer Support Program examines the effects of peer support on depression-related health outcomes in veterans receiving mental health services at VA Medical Centers in Detroit and across Michigan. The intervention is designed to reduce barriers to patient participation in mental health care, identify individuals at risk for suicide, and complement existing VA mental health services, especially in clinics with

policy and system changes to the food system.

limited resources. <

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researchDigest U-M a Leader in Health Systems Research Using data from the Web of Science database, knowledge-visualization techniques, and scientometric methods (a technique by which the state of science and technology is observed through the overall production of scientific literature at a given level of specialization), a team of researchers from China has evaluated both global scientific production and emerging trends in health systems research (HSR) from 1900 to 2012. U-M ranked among the top four academic institutions for HSR publications, with U-M SPH Professor John Piette, U-M SPH alumna (and U-M faculty member) Marcia Valenstein, U-M SPH alumnus John McCarthy, and U-M faculty member Frederic Blow among the world’s top 10 most productive authors in this area. <

Immigration Policy and Health

Detroit Free Press

n her doctoral dissertation, Alana LeBrón, PhD ’15, examined the influence of post9/11 immigration policies and attitudes on the health of Latinos in Detroit. Because of the city’s proximity to the Canadian border, residents in this border community contend with border policies, multiple immigration enforcement agencies, and Michigan’s policy to deny driver’s licenses to undocumented residents. Working with the Detroit URC’s Healthy Environments Partnership (HEP) and with the Detroit Hispanic Development Corporation, LeBrón and an assistant interviewed 50 Detroit Latinas. In particular, LeBrón wanted to know how women’s experiences with these circumstances affect both their health status and their access to social and economic resources, such as the ability to get a job or driver’s license or to remain in the U.S. LeBrón also used HEP survey data to examine links between discrimination and health for Detroit residents. <

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Black Women at Higher Risk for Lupus Young black women have the highest rate of developing lupus and are more likely to be diagnosed at a younger age than whites and during childbearing years, according to a study by Emily Somers, associate professor of environmental health sciences, medicine, and OB/GYN at U-M. In addition to experiencing the disease earlier in life—which can mean living with the condition over more years—black females with lupus also face a higher degree of serious health complications, such as kidney failure requiring dialysis or a transplant. “We found lupus to be up to three times more common than previously thought,” said Somers. “And by establishing the magnitude of the disease in specific populations, we’re better able to identify the resources we need to put toward the problem from a health care perspective.” <

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researchDigest Mental Health Program Resonates with U-M Student-Athletes Research shows that one in three college students experiences significant symptoms of depression, anxiety, or other mental health conditions—yet only about 30 percent of those students seek help. The number goes down to only 10 percent for student athletes. That’s partly because the core traits of athletes, including the need to “be tough,” often lead them to ignore their mental health needs, says Daniel Eisenberg, associate professor of health management and policy at U-M SPH.

SPH on the Frontlines: Ebola Last year’s outbreak of Ebola in West Africa put public health on the front pages—and sent members of the SPH community to the frontlines. Here’s a look at some of the activity. ► In November, the U.S. Centers for Disease Control and Prevention deployed epidemiologist Kim Lindblade, MPH ’92, PhD ’99, a 15-year CDC veteran, to Liberia to quickly investigate possible Ebola outbreaks in hard-to-reach places. Lindblade and her colleagues worked with officials in Liberia’s Ministry of Health and Social Welfare and with partner organizations to isolate rural patients with Ebola and safely transport them to the nearest Ebola treatment units. They then tracked down each patient’s contacts. By the time Lindblade left Liberia in late December, she and her team were hearing about new cases within the first few days of illness.

Only 10 percent of student athletes seek help for symptoms of depression, anxiety, or other

Eisenberg leads the research component of Athletes Connected, a new program led by SPH, the U-M Depression Center, and the U-M Department of Athletics, with support from the NCAA. Aimed at developing and evaluating mental health initiatives for student-athletes, the program has to date funded the creation of two videos featuring testimonies from former athletes about their struggles with mental illness and two videos on coping skills, as well as presentations to all U-M athletic teams and the development of biweekly support groups for ongoing help. More than 90 percent of U-M’s 900-plus studentathletes took part in the program last fall. Of those participating, 96 percent said they were likely to use what they learned, either to help themselves or others, and 40 students indicated they would like an appointment with a counselor to address an immediate concern.

W For testimonial videos, visit sph.umich. edu/mentalhealth/. <

Seyllou/AFP/Getty Images

mental health conditions.

► Clementine Fu, MPH ’13, spent several weeks in Guinea last summer conducting real-time research on the Ebola outbreak response for the International Federation of Red Cross. With so many humanitarian organizations on the ground, Fu says there was an urgent need to understand the efficacy of coordinated response activities and the challenges in messaging and communications methodologies. Fu and her colleagues identified a series of recommendations to strengthen services—including new communications strategies emphasizing the benefits of early treatment, and the use of community-based social mobilization strategies rather than passive methods like static educational posters. ► U-M SPH preventive medicine resident Aristotle Sun, MD, MPH ’12, made several trips to the Center for Domestic Preparedness in Anniston, Alabama, to take part in ongoing CDC efforts to train medical workers in how to safely care for Ebola patients. Sun conducted exercises on infection-control principles, proper and safe use of personal protective equipment, and triage for potential Ebola patients. As of late January, nearly 400 workers had taken three-day training classes in Anniston. Once trained, they were deployed to West Africa. During one training session in Anniston, Sun met with U.S. Surgeon General Vivek H. Murphy.

Research News

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researchDigest Why Health Equity Matters

Sylvain Cherkaoui/Cosmos

Years ago, while working in the U.S. Senate for the Health, Education, Labor and Pensions Committee and the Children and Families Subcommittee, Carmen R. Green found herself thinking about the concept of health equity. What exactly did it mean— not only for policymakers, but for ordinary Americans?

► Three graduates of the SPH Department of Epidemiology worked on site in West Africa to assist with Ebola treatment and prevention. Rebecca Coulborn, MPH ’08, spent 15 weeks in Guinea with Médecins Sans Frontières/Doctors Without Borders. As an officer with the CDC’s Epidemic Intelligence Service, Mariana Rosenthal, PhD ’13, was also deployed to Guinea. Working with the World Health Organization, Mikiko Senga, PhD ’13, spent 11 weeks in Sierra Leone, where she coordinated field epidemiology and surveillance for Ebola response, chiefly focusing on data management, case investigation, and contact tracing. ► While on temporary assignment to the CDC

► As part of a group of U.S. scientists involved with the Models of Infectious Disease Agents Study, an NIH-funded program focused on infectious-disease-transmission modeling, SPH epidemiology faculty members Joseph Eisenberg, Marisa Eisenberg, and Rafael Meza contributed to Ebola projections about infection rates and deaths. <

CDC.gov

AP/Sunday Alamba

Ebola team last fall, Erika Willacy, MPH ’03, lead health education specialist at the CDC specializing in refugee health, developed a CARE (Check And Report Ebola) Kit to help travelers conduct daily health checks for 21 days after returning to the U.S. from Guinea, Liberia, or Sierra Leone. For more on the kit visit cdc.gov/vhf/ebola/travelers/care-kit. html. CDC responders also included SPH graduates David Hunter, MPH ’05, who served more than 30 days in Nigeria as part of outbreak response efforts in that country; Stefanie (Anderson) Erskine, MPH ’02, who was deployed to Sierra Leone to assist with the Ebola vaccine trial; and Amanda McWhorter, MPH ’06, Gabrielle Benenson, MPH ’99, and Michael Guterbock, MPH ’08, who took on multiple assignments focused on communications, policy, and international deployment activities.

W To learn more about the school’s work in Ebola prevention and treatment, and/or to contribute your story, visit sph.umich.edu/findings.

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She’s still pondering the question. Two years ago, Green, a professor of health management and policy at U-M SPH and professor of anesthesiology and obstetrics and gynecology at the U-M Medical School, launched “The Health Equity Campaign,” which asks patients, physicians, nurses, and students to describe, in eight words or less, their idea of health equity. To date the researchers have received over 6,000 responses, mostly from the U-M community.

Green has found that high-income minorities have decreased access to pain medications, as compared to low-income whites. It’s important for health care providers to understand how different constituencies regard health equity and inclusion because it affects quality of care, says Green, whose research focuses on pain-management outcomes, physician decision-making, and access to care. “An example would be if I have a patient who is dying of breast cancer, and I think I know what she wants, based on my clinical experiences, but it’s not what the patient wants.” Studies show that poverty is the biggest risk factor for decreased quality of care, but racial, ethnic, gender, and other disparities are also factors. For example, after controlling for economic status, Green has found that high-income minorities have decreased access to pain medications, as compared to low-income whites. “So this is a health equity issue,” she says. HMP student Kisha McPherson, who is part of Green’s research team, presented a poster on the health equity study at a recent Health Disparities Summit sponsored by the U.S. Department of Health and Human Services. For more visit healthyconversations.org. <

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T u r ni ngP o ints A veteran public health leader helps build a new Detroit.

s a young LPN, Vernice Davis Anthony moved to Detroit from Philadelphia in 1965 to attend Wayne State University’s nursing school. Two years later, in July 1967, riots broke out across Detroit, and officials imposed a citywide curfew. Davis Anthony had to have a special ID to get to her job at Children’s Hospital. Her daily commute, on foot and by bus, took her past army tanks with soldiers peering out of the tops. It was, she remembers, a turning point— “both in my own life and certainly for the city.” A half-century later, Detroit is again at a turning point, and Davis Anthony, RN, MPH ’76, has been there to witness—and participate in—the change. As the immediate past director of the Detroit Department of Health and Wellness Promotion, a post she held from 2012 until her retirement this past February, Davis Anthony oversaw a massive departmental reorganization, one that coincided with the city’s emergence from bankruptcy proceedings. “I’m really positive,” she says today. “The bankruptcy allowed the city to release the burden of debt. Now it’s up to the people that live here, the investors, the business community, to get involved and work with the mayor and city council to improve our city to better serve its citizens. There’s a lot of support and belief in the new leadership.”

Rebecca Minch

Besides her three grandchildren, she is proudest “of being able to make a real sustainable difference in every step of my career.” She adds, “What the bankruptcy did not allow the city to do is to actually restructure the city so it’s functioning well, and that’s going to be difficult, and it’s not going to happen overnight.” The department she led is a part of that restructuring. The Department of Health and Wellness Promotion now reports to the Detroit’s Department of Neighborhoods, and its previously centralized activities are being distributed through community-based

Alumni Network

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organizations. Both changes are in support of Detroit’s new city charter, passed in 2012, which places greater emphasis on the city’s seven distinct districts.

As director of the Detroit Department of Health and Wellness Promotion, Davis Anthony oversaw a massive departmental reorganization. “By identifying and addressing health needs in each unique community,” Davis Anthony says, “public health strategies can be more relevant and focused, with a greater likelihood of producing better outcomes.” Additionally, the department is contracting with specialized community agencies to carry out its mission in areas like maternal and child health and infectious diseases. Wayne State University School of Medicine, for instance, now handles communicabledisease testing for Detroit—a change that “took us leaps and bounds,” Davis Anthony says. “They already have the infrastructure and staff, so it leads to a much more effective and coordinated effort.” A past director of the Michigan Department of Public Health, assistant county executive with Wayne County, director of public health nursing for the city of Detroit, and CEO of the Greater Detroit Area Health Council, Davis Anthony says that besides her three grandchildren, she is proudest “of being able to make a real sustainable difference in every step of my career.” Her advice to future public health leaders? “Stay true to your public health values—that all people deserve to be healthy and to live in healthy communities. Contribute your expertise and leadership in ways that improve lives, especially the most vulnerable and those likely to be underserved. Mentor others, and always strive to make a positive difference.” <

1950s

A past epidemiologist with the British Columbia Health Department and consultant with the British Columbia Medical Association on the topics of genetics, cancer, mental health, and neonatology, Jack Rowe, MPH ’58, reports that he still recalls “with pleasure” his association with SPH faculty Sy Axelrod and Fay Hemphill.

1970s

Edward J. McDonnell, MPH ’71, president of Compliance Management Consulting and a past director of the New England District Office of the Federal Drug Administration, has joined the board of directors of Rock Creek Pharmaceuticals, Inc.  After a nearly 40-year career in county public health in California, William Mitchell, MPH ’74, has retired. For the past 25 years, he was director of public health with San Joaquin County (Stockton).  Last spring, Evelyn Neuhaus, MPH ’72, MBA, premiered her documentary film Never A Bystander, about Holocaust survivor and U-M SPH Professor Emerita Irene Butter. The film was selected for the 2015 San Diego Jewish Film Festival.

Jack Rowe, MPH ’58, still recalls “with pleasure” his association with SPH faculty Sy Axelrod and Fay Hemphill.

1980s

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Nicole Adelman, MPH ’95, is the new executive director of the Corner Health Center in Ypsilanti, Michigan. Previously the executive director of the Interfaith Hospitality Network of Washtenaw County, Adelman began her career as a health educator at the Corner Health Center in the 1990s.  Last September, Susan Goold, MD, MHSA ’92, founder and first director of U-M’s Bioethics Program, spoke on the failures of health reform efforts in her keynote address at the Fourth Annual Medical Humanities Conference at Western Michigan University.  As executive vice president for growth, strategy and innovation at Trinity Health—one of the nation’s largest health care systems, with $14 billion in net revenue—Scott Nordlund, MBA/MHSA ’90, is responsible for all strategic planning, business development, merger, joint venture, and acquisition work, as well as system marketing and communications.

Susan Goold, MD, MHSA ’92, founder and first director of U-M’s Bioethics Program, spoke on the failures of health reform efforts.

2000s

Elaine Larkin-Leighton, MPH ’85, is director of education with the American Orthopaedic Foot & Ankle Society.  After an 18-year career with Save the Children, Mary Beth Powers, MPH ’88, has become the new CEO of SeriousFun Children’s Network, which each year provides life-affirming experiences to more than 75,000 children and their families around the world.

W For a video on Vernice Davis Anthony go to sph.umich.edu/findings/.

1990s

Washington, D.C.–based Greg Arnonin, MPH ’00, is vice president of government affairs for Marathon Pharmaceuticals LLC.  An assistant professor at the Ronald O. Perelman Department of Dermatology, New York University Langone Medical Center, Nada Elbuluk, MD, MS ’08, specializes in the treatment of skin of color, which can have unique skin conditions, as well as pigmentary disorders.  Nitin Gera, MD, MPH ’02, is a non-invasive cardiologist with the Borgess Heart Center for Excellence, part of southwest Michigan’s Borgess Heart Institute.  As a member of the medical staff at MidMichigan Health’s new medical offices in Midland, Shannon (Roehl) Martin, DO, MPH ’06, sees patients of all ages, with a special interest continued on page 45

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Gordon Studer/ iSpot.com

A Global Stage

For two SPH graduates, theater holds a key to health.

THE SCENE: A classroom in South Africa. Charles Samenow, MD, MPH ’03, is talking with former U-M SPH classmate Erika Willacy, MPH ’04, about a theater-based approach to physician training. Samenow is associate professor of psychiatry at the George Washington University School of Medicine and program director of The New Theater of Medicine, a collaboration with Jeffrey Steiger, former director of U-M’s CRLT Players. The New Theater of Medicine uses interactive theater to help train health care professionals. Willacy is a lead health education specialist at the U.S. Centers for Disease Control and Prevention. Charles: On my first day as a graduate teaching assistant at Michigan, I attended an orientation session with a troupe of actors from the U-M Center for Research on Learning and Teaching (CRLT). I said to myself, “Wow, this is the way to train people!” I’d just come from medical school, where pretty much everyone used PowerPoint slides and lectures. Theater can be so much more effective. Erika: That’s why it interests me so much. At CDC, we do trainings around the world for physicians who conduct health screenings for immigrants and refugees who want to come to the U.S. There’s a tremendous amount of variation among doctors—the skill sets they bring to the table, how they assess problems and write up reports. So I’ve been looking for ways to improve our trainings. Charles: Theater works best in areas that involve emotion— Erika: —which happens in the screening process. Some applicants have genuinely horrific stories. Others say things they think the doctors want to hear, but which aren’t necessarily true. The physicians who do our interviews are making decisions that will impact these people’s futures, so they have to be adept at dealing with emotional

triggers. Emotions can easily cloud or sway their clinical judgment— in both good and bad ways. Charles: You’re right, these are high-stakes interviews. Erika: We need to find out what illnesses they may have so they can be successfully treated as soon as possible, and we can prevent the spread of disease in their community, on the plane, and in the U.S. community where they resettle.

“At CDC, we do trainings around the world for physicians who conduct health screenings for immigrants and refugees who want to come to the U.S.” Charles: Theater can get people talking about these issues. It creates a safe space where people can observe their behavior as if looking at themselves in a mirror. In the trainings I do with health care professionals, the feedback we typically get is, “Wow, that captured my experience exactly!” When that happens, people can more objectively analyze and understand their behavior. Samenow, Willacy, and Jeffrey Steiger have conducted theater-based workshops for the CDC in South Africa and Hong Kong. Physicians from throughout the world attended. Participants have told Samenow, “This was great. It was a far better way of addressing these issues. I actually learned something. This is something I can take back and use in my practice.” <

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IN MEMORIAM

Edward W. Carney in pediatrics and women’s health.  Stephen A. Martin Jr., PhD ’01, has joined the leadership board of Jackson Healthcare’s Hospital Charitable Services Awards. Martin is executive director of the Association for Community Health Improvement at the American Hospital Association.  Danielle Turnipseed, MPP/ MHSA ’00, is vice president, prevention and population health, at America’s Health Insurance Plans, the trade association for 90 percent of the health insurance industry.

Nada Elbuluk, MD, MS ’08, specializes in the treatment of skin of color, which can have unique skin conditions.

2010s

Brenna Finley, MPH ’14, is a research specialist with the Clinical and Translational Science Institute of the University of Minnesota.  In January, Rosalyn Maben-Feaster, MD, MPH ’10, spoke to students in the U-M Health Sciences Scholars Program about the Affordable Care Act and its impact on health professionals. MabenFeaster is a staff physician with Women’s Excellence, specializing in obstetrics and gynecology and care and advocacy for women across the lifespan.  As a member of the epidemiology group of Blue Cross Blue Shield of Michigan, Sarah Mange, MPH ’10, is working on a new Medicare Advantage initiative for the management of people with multiple chronic conditions.  Steven Nelson, MPP/MPH ’14, is a health care data analyst with Blue Care Network in Southfield, Michigan. <

Sarah Mange, MPH ’10, is working on a new Medicare Advantage initiative for the management of people with multiple chronic conditions.

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1940s Morris Shiffman, MPH ’45  October 6, 2014 Jeannette J. Simmons, MPH ’45  January 19, 2015

1950s Frieda H. Jardim, BSPHN ’50  August 1, 2014 Clare E. Forbes, MPH ’52  October 15, 2014 Alfredo A. Ehlers, MPH ’53  December 3, 2014 (date U-M notified of death) Adrian J. Oudbier, BSPH ’53; MPH ‘65  December 28, 2014 Vinson R. Oviatt, MPH ’53  December 13, 2014 Janet M. Bosshart, MPH ’58  October 20, 2014 Richard B. Morgan, MPH ’59  February 4, 2015

1960s Amy D. Geissinger, MPH ’62  November 1, 2014 Gertrude Z. Lowell, MPH ’65  October 24, 2014 Martha S. Hearron, MPH ’66  November 29, 2014 Alan T. Wills, MPH ’66  March 12, 2009 Jerry A. Woollen, MPH ’66  January 9, 2015 Jack E. Peterson, PhD ’68  March 27, 2014

1970s Mary M. Miller, MPH ’72  November 6, 2014 Barney P. Vandyke, MPH ’73  May 21, 2014 Peter D. Magnus, MPH ’75  September 19, 2014 (date U-M notified of death) Walter L. Young, MHA ’75  March 6, 2015 (date U-M notified of death) Linda M. Roberts, MPH ’76  January 22, 2015

1980s Bobby G. Bryant, MS ’86

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November 19, 2014

1990s Robert R. Brems, MPH ’90  January 15, 2015 Rhoda M. Powsner, MHSA ’90  August 21, 2014

2000s Garry J. Bundy, MPH ’01  November 4, 2014 Lori S. Swarts, MHSA ’06  July 24, 2014

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Edward Walter Carney, PhD, an adjunct associate professor of environmental health sciences, died suddenly on January 12, 2015, while running on Michigan’s Pere Marquette Rail Trail. He was 55. The Scientific Director for Toxicology Research at the Dow Chemical Company in Midland, Michigan, and leader of Dow’s Predictive Safety Assessment program, Carney received his PhD in reproductive physiology from Cornell University and conducted postdoctoral research in molecular developmental biology at the Samuel Lunenfield Research Institute in Toronto. His research interests included in vitro developmental toxicity, developmental toxicokinetics, and integrated approaches to predicting toxicity using in vitro and in silico approaches. In addition to his faculty appointment at U-M SPH, Carney taught in the University of Surrey (UK) Master’s Programme in Toxicology. He published over 100 peer-reviewed papers and held numerous external positions, among them the U.S. Environmental Protection Agency Chartered Scientific Advisory Board and Board of Scientific Counselors, the European Centre for the Validation of Alternative Methods Science Advisory Board, the Hamner Institute’s board of directors, the Teratology Society, the Society of Toxicology, and the U.S. Humane Society’s Human Toxicology Project Consortium. Carney had recently accepted assignments at the Joint Research Centre of the European Commission and the U.S. EPA National Center for Computational Toxicology. A gifted musician whose interests included saxophone, clarinet, jazz, and world music, Carney played in local bands and supported music education through volunteer work with the Dow and Meridian High School jazz bands, ACT-SO, and as founder of Michigan Jazz Trail Jam sessions for local high school students. He is survived by his wife, Nancy, and sons Alexander, of Berkeley, California; Kevin of Paris, France; and Philip of Midland, Michigan. <

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IN MEMORIAM

Victor M. Hawthorne Victor M. Hawthorne, professor emeritus of epidemiology at U-M SPH and in the Department of Family Practice in the U-M Medical School, died in Lansing, Michigan, on November 23, 2014, of heart failure. He was 93. Hawthorne was a graduate of the University of Glasgow, where he received the MB and ChB (bachelor of medicine and surgery) degrees in 1951, MD degree (with commendation) in 1962, and Doctor of Science (honorary) degree in 1996. Early in his career, he was involved in tuberculosis control in Scotland, which stimulated future interests in epidemiology and preventive medicine. His studies of respiratory diseases and hypertension in Scotland led to an appointment in 1966 as senior lecturer at the University of

In 1986, the Michigan Department of Public Health established the Victor M. Hawthorne Awards.

Glasgow Department of Epidemiology and Preventive Medicine. As the principal investigator in the Paisley and Renfrew MIDSPAN Health Study of 15,000 men and women screened for cardio-respiratory diseases, Hawthorne identified many of the important risk factors that predict excessive mortality due to coronary heart disease and other common chronic diseases, and, of related interest, the effect of environmental tobacco smoke on the health status of non-smokers. Hawthorne came to U-M in 1978 as professor of epidemiology and chair of the Department of Epidemiology and in 1982 received an additional appointment in the Department of Family Practice. In 1991 he was named professor

emeritus of epidemiology and family practice, but remained active in research and practice until shortly before his death, publishing his last article in 2009. He served as a member of the Governor’s Chronic Disease Advisory Committee from its inception in 1978. In 1986, the Michigan Department of Public Health established the Victor M. Hawthorne Awards for research projects in disease prevention and health promotion. Hawthorne is survived by his daughters Wendy Hawthorne and Rosalind (William) Kirk, three grandchildren, and two great-grandchildren. His wife of 65 years, Jean Mackenzie, and daughter Hilary predeceased him. Contributions to his memory may be made to U-M SPH. <

Steven P. Levine Steven P. Levine, professor emeritus of industrial health at U-M SPH, died in Jupiter, Florida, on March 29, 2015, of pancreatic cancer. He was 71. With degrees in chemistry from City University of New York (BS, 1965) and in analytical chemistry from the University of Colorado (PhD, 1972), Levine joined the Veterans Administration Hospital Research Center in Denver as a postdoctoral research scientist in 1971. A distinguished career in industry followed at the Stauffer Chemical Company, Ford Motor Company, and Oil and Hazardous Material Corporation. Levine joined the U-M faculty in 1982 and was named Professor Emeritus of Industrial Health in 2003. Early in his teaching career, Levine researched the determination of very small amounts of chemicals in complex matrices and in environmental media, including air. This was his introduction to the field of environmental and occupational health, which became his pri-

Levine gave talks to medical professionals and health care organizations about his experience as a patient.

mary interest. He later extended his interests to the monitoring of gaseous contaminants in working environments, with special emphasis on the development and application of advanced infrared detection and quantitation techniques. In the 1990s, he began to study and develop management systems for the protection of industrial workers, and became a prominent leader in the field of environmental safety and health management and policy. In a career that spanned three decades, Levine contributed significantly to international standards and World Health Organization–legal means of ensuring environmental health and safety-system quality, the international harmonization of management systems, and the relations between U.S. national and applicable international regulations. He published over 100 peer-reviewed works and

served on many national and international committees and advisory councils. In 1998, following a motorcycle accident that left him with multiple broken bones and a series of complications, Levine gave talks to medical professionals and health care organizations about his experience as a patient, and he published “A Patient’s Perspective” in the U-M SPH magazine, Findings. “By giving my own perspective on the health care experience, I hope to shed light on the issues my public health colleagues face every day in our efforts to reduce the cost and improve the quality of the care on which our lives depend,” he said. Levine is survived by his wife, Barbara. Contributions in his memory may be made to the U-M SPH Environmental Health Scholarship Fund or Hospice of Palm Beach County. <

At the School of Public Health, we believe in

entrepreneurship

and innovation, because we know that for learning to be effective it must extend beyond the classroom. Our students are innovators, working to solve public health problems through creativity, intelligence, drive, and collaboration. We support them by equipping them with the skills they’ll need for the future: statistical know-how, written communication, cultural humility, political savvy, global experience, local expertise, and a keen grasp of entrepreneurship. But many of our students can’t afford this education without financial support. We invite you to invest in the next generation of public health leaders and innovators. Join us. Be a Victor for Michigan.

Photos were taken at the 2014–2015 Innovation in Action competition by Peter Smith

Victors for Michigan.

Bold Thinking

Peter Smith

For a few years after graduating from U-M SPH, Bloom worked as an environmental scientist, until four friends persuaded him to join them in founding a proprietary trading firm. Bloom says he found his feet by drawing on his SPH course work in statistics, quantitative analysis, decision-making, and speaking. “I also had to teach myself a lot of new skills,” he adds, “but my degree gave me the confidence I needed to venture outside my comfort zone.”

“This school has a national reputation for providing a fertile environment where boldness and creativity are highly valued,” he notes. “That’s how significant public health innovations come about. Excellent training in public health enables a practitioner to identify a need. But it’s often business acumen and an entrepreneurial mindset that help to successfully implement an idea in the real world where people can benefit.” v

The yearly competition—a key initiative of the SPH Office of Innovation and Social Entrepreneurship—invites students to be thoughtful risk-takers as they strive to make a positive difference in the world. It also equips students with the necessary entrepreneurial skills to launch their innovations. “An increasing number of students want to make a public health impact through the marketplace,” says Vic Strecher, director for innovation and social entrepreneurship at SPH. “Their efforts, developed through the SPH Innovation in Action Program, demonstrate that highly innovative and sustainable products and services can be created using a market-based, or entrepreneurial, approach.” For more visit sph.umich.edu/iia.

Now an independent investor, Bloom says he wants to help other SPH graduates apply tools from the world of business to solve public health problems. The Bloom Family Gift to U-M SPH will strengthen and expand the entrepreneurial culture that is already taking root at the school. The gift will help fund an entrepreneur-in-residence in the SPH Office of Innovation and Social Entrepreneurship, who will work with faculty and students to develop sustainable and scalable market-based solutions to a vast number of public health challenges. This is particularly important at a time when government and private grant funding is decreasing, says Bloom, a long-time member of the SPH Dean’s Advisory Board.

In the final event of the second annual SPH student competition “Innovation in Action: Solutions to Public Health Challenges,” six teams pitched their innovations to the public and a panel of judges. The student innovators grappled with public health dilemmas and offered practical solutions: a culturally tailored diabetes curriculum for Native American communities; an affordable grab-n-go dinner kit, available at community centers and transit stations; a service to connect low-income communities with grocery stores; and the winning entry, an app to help HIV patients manage medication.

Steven H. Bloom, MPH ’81, has proven time and again that a public health degree can serve a person well in any profession—including the high-stakes world of finance and investment management.

Innovation in Action Competition

Creative Solutions

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Alison Jensen: Improving Access to Fresh Food Peter Smith

To address the problem of food insecurity, first-year SPH student Alison (Ali) Jensen entered the school’s 2014–2015 Innovation in Action competition as part of a fourperson interdisciplinary team. She and her colleagues created Fresh Fare: an interface between grocery stores and rideshare programs, designed to give low-income residents access to healthy foods. “We interviewed tons of stakeholders about food access,” explains Jensen, a U-M SPH Dean’s Scholar. Three issues arose as the biggest barriers to food access: unemployment, poverty, and transportation. Each teammate brought five or six ideas for the project. “We walked away with Fresh Fare,” says Jensen. Soon after, they pitched their idea to a corporate responsibility head from Meijer, a Michigan-based hypermarket chain, who was attending a U-M job fair. The pitch earned an invitation to the company’s Grand Rapids corporate headquarters. “They loved it,” Jensen recalls. In fact, Meijer contributed almost $4,000 to run a pilot in Detroit this spring.

Fresh Fare is designed to give low-income residents access to healthy foods.

“I’m here for more than just sitting in a classroom,” says Jensen. “I want to make a difference in the world.”

Peter Smith

Nora White: PreLeaf

Nora White wants to help people with diabetes live healthier lives and possibly even eliminate their symptoms. For the 2014–2015 Innovation in Action competition, White and two teammates developed an app to assist pre-diabetic patients with meal selection and preparation. The app includes interactive video clips with recipes, nutrition information, and step-by-step cooking instructions. “You can go to your resource for cooking, you can go to your resource for diabetes,” says White, a second-year MPH student and Dean’s Scholar. The app connects the dots between these resources, streamlining—and enhancing—the process of adopting new eating habits. Going forward, White hopes to establish a health-driven community center that assists patients in changing their lifestyle habits. The community center would establish long-term relationships with patients as they learn where food comes from and how different foods make them feel. “That’s the spirit of innovation I can see myself carrying into the future,” she says.

“That’s the spirit of innovation I can see myself carrying into the future.” o

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Peter Smith

A single scholarship can lead to

global change.

Help make the difference by giving now. “My scholarship goes beyond just financial support, as it demonstrates to me my school’s commitment to help make my vision a reality. I’ve been able to develop that vision in part through my involvement in the SPH Peter Smith

Innovation in Action competition, which encouraged me to go beyond traditional academic methods of problem-solving and to explore and develop new,

creative, and tangible solutions to revolutionize the patient experience.” —Saurabh Kukreti, MHSA (’16) candidate, John R. Griffith Scholarship Read about other U-M SPH scholarship recipients at sph.umich.edu/giving.

The University of Michigan will match qualifying student support gifts at one dollar to every four dollars you contribute. sph.umich.edu/giving

New on the web

July 12–31, 2015

50 Years: Graduate Summer Session in Epidemiology

online at sph . u m ich . e d u

> New School of

Public Health Website

If you’ve visited the SPH website recently, you have likely noticed some major changes. Our site’s design is completely new. Its structure and navigation have been reconfigured to make it easier to use, and it’s all mobile-friendly. In the next few months, we’ll be working to enhance your experience even more—look for a new Findings site, an integrated video library, and stories that highlight the best of SPH.

> Spring Break on the Frontlines

Monday, July 13, 5:15 pm, U-M SPH Leonard M. Schuman Lecture “So You Think You Can Innovate?” Roberta B. Ness, MD, MPH James W. Rockwell Professor in Public Health; Vice President for Innovation The University of Texas Health Science Center at Houston School of Public Health

The Public Health Action Support Team, a student group that helps health departments and community organizations with public health projects, spent spring break volunteering in Grenada and South Texas. The students blogged about their experiences on the public health frontlines: umsphfrontlines.wordpress.com.

> Innovation

in Action

Student teams from across campus accepted the challenge to develop solutions to real-world pubic health issues through the Innovation in Action competition. Teams developed their projects and pitches for six months and revealed their innovations to the public at a competitive final event. Learn about the winning teams and their innovations at sph.umich.edu/iia.

Wednesday, July 22, 3:15-5 pm, U-M SPH Alfred S. Evans Panel Discussion “The Burden of Chronic Diseases in the 21st Century” Moderator & Panelist: David Schottenfeld, MD, MSc Panelists: Ana Diez Roux, MD, PhD, MPH Frank Hu, MD, PhD, MPH ; Michael Thun, MD, MS

> Something to Say?

KEEP IN TOUCH

Comment online on any story in this magazine and learn what other readers have to say at sph.umich.edu/findings.

> If you would like to be part

Want to share your realworld knowledge and experience with current or prospective students? Need a job or have one to fill?

of Ask an Alum, please send an email to sph.inquiries@ umich.edu.

> SPH Career Connection

info from our home page at

matches SPH students and grads with companies and agencies. Check out umsphjobs.org or e-mail sph.jobs@ umich.edu.

U N I V E R S I T Y

O F

> Update your SPH contact sph.umich.edu. Or indicate changes on the address label and mail to the address on the back cover.

M I C H I G A N

S C H O O L

Join us as this internationally recognized program celebrates 50 years of providing instruction in the principles, methods, and applications of epidemiology.

O F

Wednesday, July 29, 5:15 pm, U-M SPH David Schottenfeld Keynote Address “How Epidemiology Has Improved Population Health and Will Continue to Do So” Jonathan M. Samet, MD, MS Distinguished Professor and Flora L. Thorton Chair, Department of Preventive Medicine, Keck School of Medicine; Director, USC Institute for Global Health, University of Southern California For more information visit SummerEpi.org.

P U B L I C

H E A L T H

S P H . U M I C H . E D U

Food City W

hen it comes to food, Detroit is a tale of many cities. Foodie meccas like Midtown boast dozens of trend-setting restaurants and cafés—and the city’s first Whole Foods (a second is in the works, as is a Meijer’s). New food havens are springing up in neighborhoods like Southwest (home to popular Café con Leche) and Grandmont Rosedale, where two-year-old Always Brewing has become a magnet for longtime residents like Mary and Chet McLeod, who say the coffee shop is “like our Cheers. We’ve been dying for a place like this.”

“It’s really encouraging that so much positive is happening,” says SPH graduate Noam Kimelman, MPH ’12, founder and owner of Fresh Corner Café, which delivers healthy food to small-scale retailers throughout Detroit. Among the scores of new eateries opening citywide, many are “really intentional about sourcing Michigan- or Detroit-grown produce and other local products,” Kimelman adds. But in some pockets of the city, access to healthy foods—never mind convivial cafés—is scarce, and many Detroiters continue to rely on fast food or cheap snacks from corner stores and gas stations as their default cuisine. Kimelman, who won the 2014 Young Entrepreneur Award from SCORE, a national organization that aids small businesses, wants to spread the culinary wealth. And he’s not alone. At D-Town Farm on the city’s west side, Malik Kenyatta Yakini and his colleagues are growing more than 30 kinds of fruits and vegetables with an eye toward increasing access to high-quality fresh produce. Yakini, director of the Detroit Black Community Food Security Network, believes agriculture “can be an economic driver in Detroit.” Dorceta Taylor of the U-M School of Natural Resources and Environment says urban farms are but one way Detroiters meet their food needs. The city’s “vibrant alternative food scene.” she says,

includes community and school gardens, farmers markets, dairies, community-supported agriculture, mobile food trucks (such as UpSouth Foods, which imports produce from black farmers in the South), soup kitchens, food pantries and banks, even subsistence fishing and hunting. Taylor gave the keynote at this year’s Minority Health Conference sponsored by Public Health Students of African Descent at U-M SPH. At FoodLab Detroit, more than 100 food entrepreuneurs are working to create a “sustainable local food economy in Detroit,” reports co-director Devita Davison. FoodLab members—many of whom come from traditionally marginalized populations—hew to a triple bottom line: financial profit, environmental sustainability, and social equity.

And a new generation is in training. Through the Detroit Food Academy, an after-school program for high-schoolers, Kimelman and others are helping young Detroiters learn basic business, cooking, and nutritional skills. The students develop food products to sell through another new enterprise—Small Batch Detroit. Detroit’s food scene, says Kimelman, “is really thriving.” <

People

1. Noam Kimelman 2. Malik Kenyatta Yakini 3. Alicia George of Motor City Java House 4. Jordi Carbonell of Café con Leche 5. Devita Davidson of Food Lab 6. Jennifer, Cassandra, and Charice Thomas of Sweet Potato Sensations 7. April Anderson of Good Cakes and Bakes 8. Deveri Gifford and Jason Yates of Brooklyn Street Local 9. Loyal customers Mary and Chet McLeod at Always Brewing

Businesses & organizations pictured Always Brewing Avalon Bakery Sweet Potato Sensations Motor City Java House Café con Leche

Brooklyn Street Local Slows Bar B Q Fresh Corner Café FoodLab Eastern Market

Detroit Food Academy Good Cakes and Bakes Small Batch Detroit Mitten Bites

Photos: Rebecca Minch, Peter Smith, Detroit Food Academy, Detroit Community Markets, Brooklyn Street Local, Café con Leche, Good Cakes and Bakes, Motor City Java House, Slows Bar B Q, Sweet Potato Sensations, and others

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The only way to

ensure the health

of our world is to protect the people who live in it.

Wherever the toughest challenges in public health may be, we will be on the front lines, creating new and exploratory paths through deep science and global action that will lead to the elegant and meaningful solutions the world needs. There is no end to what we

—and the leaders we are creating—can accomplish. Global health challenges are multiplying every day. We at the University of Michigan School of Public Health work passionately beyond the classroom to bring viable solutions to the world’s most pressing problems. sph.umich.edu