Bringing Public Health into Urban Revitalization: Workshop Summary by Robert Pool

Author:Robert Pool
Language: eng
Format: epub
ISBN: 0309379989
Publisher: The National Academies Press
Published: 2015-12-23T00:00:00+00:00

DISCUSSION

John Balbus of the National Institute of Environmental Health Sciences opened the discussion session by asking the speakers to comment about how the work that they are doing in empowering the community is being reflected in the institutions of the city of Detroit and how it is leading to a sustainable transformation of the status quo and the way in which things are done.

Wisdom answered that one of the ways is through the efforts to employ community health workers. “This is not something that many of us in health care have heard about, particularly those on the clinical side,” she said. Bringing these workers in to help those in the health care industry engage community members is one example of a transformational change.

Davis approached the question from a different angle: “Our effort actually is being led by a grass roots community group, which is transformational in itself,” she said. Depending on the particular issue, different groups are taking the lead in looking for solutions, but none of those groups are composed of people whose salaries are being paid by organizations that have some interest in the status quo, so it makes it easier for them to “speak truth to power,” Davis said.

Wisdom added that another example is that the Henry Ford Health System is working closely with three other health systems—the Detroit Medical Center, Oakwood Health Care, and St. John Providence—even though they compete for market share. Cooperating with them on community improvement efforts is transformational, Wisdom said. Yet another example is the way that the health system is taking a “collective impact approach,” bringing together all of the stakeholders affected by a particular issue and using a multisectoral approach to address the problems. “We can’t address them the same way by being in our silos,” she said. “We have to come together at a common table with that shared power in order to truly drive change.”

In response to a question from Jack Spengler of Harvard University, Wisdom said that the Henry Ford Health System has a very robust program to drive down the company’s health care costs by encouraging its employees to change their behavior in ways that improve their health. Employees are given health risk appraisals and then offered suggestions for changes in behavior and lifestyle. “We see a direct correlation,” she said. “When our scores go up related to our lifestyle risk score, we also see that it increases productivity and it decreases costs.” The health system is also interested in taking what it learns from working with its employees in this way and applying those lessons in the broader community, Wisdom said.

Brett Van Akkeren from EPA commented that one of the reasons that groups of artists moved to and thrived in Soho in Manhattan was that the government there was ineffective and did not enforce its zoning laws. This allowed artists to populate Soho, even though it was supposed to be an industrial area. “So you’ve got to make sure that government stays out of the way sometimes and lets people be creative,” he said.

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