How Michigan is Working to Address Health Inequities and Disparities by Race
“If not addressed, health inequities have significant costs in the form of lost or unrealized human, social, and economic potential for our state. With effective public health and human service efforts in our state, we can expect to spend less on preventable health costs, have a more productive workforce and make Michigan a better place to live for everyone.” – from Michigan Department of Health and Human Services Health Equity Online Training
When it comes to health outcomes, it’s not always genetic code that most influences how healthy we are. Sometimes it boils down to zip code, explains Brenda Jegede, manager, Health Disparities Reduction & Minority Health Section, Policy & Innovation Division, Michigan Department of Health and Human Services (MDHHS).
How safe you feel in your home, whether you have access to parks, sidewalks, reliable transportation and fresh food – these are all determined in large part by where you live. They affect your health, but your doctor can’t write you a prescription to solve these so-called social determinants of health, which also include housing, education, job security, social connection and living wages.
“All of those things connect to health outcomes,” Jegede said.
Since unfavorable social determinants of health tend to disproportionately affect Michigan’s populations of color, Jegede’s section is charged with collecting data on specific populations and focusing on building health equity in communities and reducing disparities. The Health Disparities Reduction & Minority Health Section (HDRMHS) works to address health disparities in the following populations:
- African Americans
- American Indians/Alaska Natives
- Arab and Chaldean Americans
- Asian Americans and Pacific Islanders
They do this by empowering communities to identify the issues they want and need to work on. Jegede said the state provides support by offering data and connecting like-minded people and organizations together, as well as providing capacity-building grants to address inequities. But when it comes to solutions, there is no one-size-fits-all approach.
“The community has to tell us what the priorities are,” Jegede said. “They’re the best experts in that.”
Shronda Grigsby works as a public health consultant for the HDRMHS. She’s excited about many of the division’s community success stories over the years, including:
- After Michigan’s Medicaid expansion through the Healthy Michigan plan, the section worked with a Mercy Primary Care Clinic in Detroit to develop and implement strategies to improve access to care through addressing health literacy. The grant also supported the doctor’s office in either supplementing the wages or hiring a part-time community health worker who helped newly insured patients understand their benefits. Feedback surveys from patients showed that 95 percent now viewed themselves as a partner in their health care and 93 percent said they intend to take more responsibility for their health. Ninety percent said they felt better able to communicate with their physician and 87 percent responded that they intend to visit a primary care physician regularly.
- Through a partnership with the St. John Health System in Detroit, a Neighborhood Health and Safety office was established in targeted neighborhoods. Ten community champions were trained and a partnership with the police department provided neighborhood patrols a direct link to police to report crime. Between 2009 and 2011, the project reported a 13.5 percent reduction in violent crimes. Property-related crimes also decreased more than 20 percent. The program was so successful, the health system added it as a line item to their budget to continue beyond the initial state funding.
- In Flint, the Genesee Health Plan partnered with the Mass Transportation Authority to improve access to transportation for Spanish-speaking community members. Translated signage and route guides, along with distribution of no-cost bus tickets helped people get where they need to go and the implementation of a “Rides to Wellness” program offered door-to-door transportation to medical appointments, the grocery store and other community resources.
Grigsby said building authentic relationships with community leaders is an important part of the work she does with HDRMHS. Empowering populations to come up with solutions that work and implement them is critical to the success of the program, a point Jegede agrees with.
“Trust is a really important thing,” she said. “We have to work on that with communities – especially when we’re building trust with ethnic and minority populations where that trust might have been broken in the past.”
Learn more about the work being done by the state’s HDRMHS here.
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Photo credit: laflor