When it comes to community health, the social determinants and resources of geography and the population help build the culture.
Think about health and nutrition, air and water quality, income levels, employment rates, recreational offerings, mental health, or access to healthcare. These are just a few of the components that make up a community’s culture of health.
Historically, Wayne County has the worst health ranking of all the counties in Michigan. According to the 2018 Wayne County Health Rankings, as reported by the Robert Wood Johnson Foundation, Wayne County ranked 83rd in overall health outcomes. That's out of 83 Michigan counties.
The statistics look bleak. But considering Wayne County's under- and unemployment rates, asthma rates, graduation rates, and the excess of heavy industry polluting the air and water, it becomes much clearer why those rankings are the way they are.
But a culture of health is emerging.
Given the poor health outcome performance of Wayne County, it may seem audacious to think a culture of health is emerging. But it is. Just as the Slow Roll in Detroit grew into a vast parade of vitality, trails and greenways are expanding, schools are rethinking healthy educational environments, farm markets and other fresh food providers are abundant. Healthy community initiatives are sprouting up in communities throughout the county. These are all initiatives that have either been driven by people at the grassroots level or strongly supported by average, moderately fit people.
It’s sustainable, though perhaps, right now, not very visible in this vast, diverse tract of land that is home to 1.7 million people living in 43 communities over an area of 673 square miles.
But people in Wayne County are changing the way they live, slowly. Progress is seen in the discovery of the taste of red pears, choosing healthy restaurant entrees, starting a walking routine on a new exercise trail, or the resilience that comes from collective support for those caring for children of opioid addicts.
In a broader sense, it’s about advocating for school wellness policies, municipal health policies, and creating citizen scientists.
But a foundation exists and projects are underway that will help to continue a change for the better in Wayne County’s health outcomes, and will help contribute to stronger, healthier lifestyles across all its communities.
To demonstrate this, we created a map of the organizations, projects, and community efforts that are contributing to Wayne County’s emerging culture of health.
What we learned is that the future is looking bright and that more work is needed.
Healthy community design needs to address the most important part of any community: healthy people. It does little good to have attractive streetscapes, good schools, and abundant employment, if people can’t or won’t exercise, students can’t learn, and workplace absenteeism is high. Community health centers, farmers markets, trailways and greenways, community health initiatives, and more are all working to help improve health outcomes and quality of life.
In this series, we set out to find evidence of this emerging culture, document it, and visualize it. Through eight feature articles, we sought to offer the region the first dedicated coverage of population health.
Below are just a few of these initiatives that we have covered:
Deborah Lynch at her Grosse Pointe Seed Library.
The Dearborn Public Library and Grosse Pointe Public Library are examples of how libraries are reinventing themselves, in this case becoming more involved in promoting health literacy. By understanding the science and practice of planting heirloom seeds, then eventually realizing the nutritious difference of fresh vegetables from one’s garden, helps people change the way they look at their options in grocery stores, and ultimately what they choose to eat. The libraries reflect a broader social movement that is making libraries a source of health information.
"It became that much more poignant how disconnected people are from their food source and the food system, and really don’t understand it… I’ve heard comments that ‘I don’t want to plant a tomato plant because it would be in the dirt and I’d have dirty food. Many people have no idea what they are putting into their bodies." - Kate Pepin, Healthy Dearborn
Change in a culture doesn’t come from politicians or academicians, but from average people who organize around the idea of healthy communities. It certainly doesn’t come quickly. Healthy systems, challenged by the Affordable Care Act, have become more invested in promoting the well-being of communities they serve through Healthy Dearborn and Healthy Livonia, among other healthy community initiatives. It’s a world-wide movement that began with the World Health Organization and is growing throughout Southeast Michigan.
"I do see a culture of health emerging. We have a long way to go to make large scale change in health. With the different political environments, sometimes you make progress and sometimes it stalls. This is going to take a long time." - Betty Priskorn, vice president of Community Health and Outreach, Beaumont Health
Environmental Health Research-to-Action (EHRA) Academy
The idea of empowering people living in the nexus of a regional industrial corridor by training “citizen scientists” is taking hold in Southwest Detroit and South Dearborn. By mobilizing average people to understand the health risks of the manufacturing environment, particularly as it pertains to air quality, the Environmental Health Research-to-Action (EHRA) team created a program to educate young people about community science and policy advocacy to address environmental health inequities. The academy begins focused on the environmental health inequities experienced by Arab Americans, as an overlooked public health issue in Southeast Michigan. The goal of this project is to expand the existing EHRA Academy to improve environmental health locally and create a sustainable model for youth development in environmental health science and policy advocacy.
“I want to fight for my community. I want to be a part of something bigger. This program gave me a platform to stand right beside my fellow community activists to advocate for environmental justice… I want to be a civic leader and expand this mentality to the youth and for future generations of many struggling communities.” - Hadi Nasserdine, a Dearborn student who participated in the Environmental Research Health Academy
Healthy Trenton, a community health initiative, figured prominently in creating an important in Michigan’s Iron Belle Trail. It's important not that it gives cross country runners and cyclists a longer trail, but because it gives moderately fit people the incentive to get off the couch and doing something physical.
“Trails often encourage inactive people to become active and modestly increase the activity levels of already-active residents,” - Megan Lawson, Ph.D., a public health economist who has measured the health benefit of trails for Headwaters Economics
Thousands of grandparents in Wayne County are meeting the challenge of caring for the children of their opioid addicted children and preventing this public health crisis from extending into neglected youth. Seniors, anticipating retirement, are finding themselves becoming parents again. Resilience, in through information and communal support, is a bright spot in the seemingly overwhelming epidemic.
"I hear over and over that children are resilient…Children are only resilient to an end. You can't keep exposing them to trauma after trauma, uncertainty, instability, and expect that they are fine, happy, well-adjusted citizens once they become adults. Statistically, that is not possible. - Christina Wasilewski, president, Downriver Michigan Chapter, Grandparents Raising Grandchildren
Allen Attee at U of M Dearborn's Picasso Cafe. Photo by David Lewinski
The federal Let’s Move campaign and legislation have given chefs and food service managers a challenge of creating more nutritious menu items that students will eat. With challenge comes opportunity. From grade school to college a major strategy in the fight against childhood obesity is creating nutritious food that is actually being eaten by students.
"The interesting thing was, they thought they [pears] were apples. Some were reluctant. But as their friends tried it and they liked it, then the ones who refused it the first time would come up to try it…” - Karen Cumming, Director of School Dining Services, South Redford Schools, explaining the reaction of students to different colored pears.
Dr. Maureen Connolly.
Imagine being an LGBTQ teenager thrown out of your home, living on the streets, finding out you're HIV positive and trying to navigate the healthcare system your own. Or imagine being a homeless transgender teen getting jeered at by other patients in the waiting room of a community health clinic. We focused on the work of the Ruth Ellis Center, based in Highland Park. The organization's drop-in center was already offering "low-barrier" access to food, showers, laundry facilities, recreation, and peer support. But when staff asked how they could better serve their clients, they found that the homeless LGBTQ youth they served were still facing significant barriers in accessing primary care services.
"We found out that not only were more than 90 percent not connected to primary care, but about 40 percent were also already living with HIV… When you don't have family support and you're experiencing identity-based rejection, it's really hard for a young person to navigate the healthcare system or enroll in Medicaid." - Mark Erwin-McCormick, director of development and advancement for the Ruth Ellis Center.
Every movement has its beginning. Every beginning has its advocates who work for change. Since community health effects, well, the entire community, it takes everyone being aware and involved to create lasting change.
Something is happening in the state’s sickest county, and it’s driven by communities. Now it is up to Wayne County’s communities as a whole to take the good news about health and build on it.
Join us for a community conversation on how we are creating a culture of health in Dearborn and Wayne County.