Health disparities in the news

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Wayne State develops novel geocoded map to improve health outcomes

If you live in southeast Michigan, your ZIP code may determine how long you live. Live in the 48236 ZIP of Grosse Pointe and at birth you can expect to live to an average of 82 years. Just a few short miles away, however, if you’re born and live in the Detroit ZIP of 48201, you can shave 13 years off that respectable mark. The 13-year loss can be attributed to numerous factors, including a lack of access to healthy food, health care and safe places to exercise. Resource limitations and socioeconomic disparities in the 48201 ZIP code also contribute to soaring levels of toxic stress and poor health. That stress often manifests in the form of disproportionate levels of high blood pressure, which, if uncontrolled, brings on a host of illness guaranteed to shorten lifespan. That’s the bad news.
The good news, as attendees of the Detroit Regional Chamber’s annual Mackinac Policy Conference heard Thursday morning, is that a radically new form of mapping health data by census tract may give policymakers, researchers and health care providers the information they need to design targeted efforts to improve health in areas with a long history of worse outcomes. The goal, said Phillip Levy, assistant vice president of Translational Science and Clinical Research Innovation for Wayne State University, is to develop a precision approach to population health, guided by data provided by drilling down as far as possible, perhaps even to individual neighborhoods.
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Addressing mental health key to improving criminal justice system

Diverting individuals with mental health disorders into treatment programs rather than simply jailing them not only significantly reduces the jail population but also lowers the chances of recidivism among offenders, according to a five-year study conducted by the Center for Behavioral Health and Justice at Wayne State University’s School of Social Work and released by the state of Michigan. According to the study, 54 percent of all individuals booked into jails in the target counties reported some variation of a substance abuse problem, while 45 percent described themselves as housing insecure and 42 percent said they had been recently incarcerated. Meanwhile, 34 percent had some indication of mental illness. “More than just a collection of data, this report offers us an early roadmap to drastic improvements in how our criminal justice system handles issues of mental illness and substance abuse,” said Sheryl Kubiak, dean of the Wayne State School of Social Work and the principal investigator for the study. “In addressing these issues, we also give ourselves opportunity to address many of the problems that these issues underlie, including jail overcrowding, poor access to mental health, and drug treatment and recidivism.” Drug abuse presented an equally thorny problem for many jails, said Kubiak. “Most jails have little therapy or protocols for inmates suffering withdrawals,” she said. “Some just hand out blankets and Gatorade and think that’s enough.” Kubiak concludes: “As the study proves, when we simply lock up mentally ill or addicted individuals with no real plan to get them help, we’re only prolonging and exacerbating problems that we have the tools to effectively address.”  
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High blood pressure is rampant in Michigan. Better data may lead to a cure

“You can throw all the medicines you want at the [hypertension] problem, but if you can’t fix the upstream social determinants, you’ll never solve it,” said Dr. Phillip Levy, an emergency room physician at Detroit Receiving Hospital and cardiovascular researcher who developed the tool. Levy’s work will be presented Thursday at the Detroit Regional Chamber Mackinac Policy Conference. If all goes well, the map could one day address health disparities at the street level throughout Michigan, combining neighborhood health data with demographic information such as age, race, demographics, income, insurance coverage, pollutants, access to transportation, fresh food and more. “This is about using information to address adverse health outcomes of the state. We know that heart disease disproportionately affects Detroit, so it makes sense to start there,” he said. Levy’s work is part of an emerging focus in health care on “precision public health, as more practitioners, public health advocates, and even community leaders and businesses better understand that certain demographics and neighborhoods carry more “disease burden” than others.
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How technology bridges gaps between healthcare and underserved populations

Steven Ondersma discovered that "only a very small proportion, maybe 10 percent" of the people who need professional care realize that need and have the means to address it. "I've just become really interested in having whole-population effects, rather than helping a few people who might be ready to make use of the treatment and have access to that treatment," says Ondersma, deputy director of the Merrill Palmer Skillman Institute at Wayne State University. Ondersma and others in Michigan who are interested in addressing the social determinants of health have increasingly turned to technology as an answer to that question. Weisong Shi, professor of computer science at Wayne State envisions the potential for technology to bring a doctor's office to those more remote patients. He proposes a vehicle, "just like an ice cream truck," that would allow people to get basic physical tests in their communities, with the results being transmitted back to a provider's office. Asthma disproportionately affects African-Americans nationwide, but in Detroit the problem is particularly pronounced – and often an emergency situation. Karen MacDonell, associate professor in Wayne State’s School of Medicine, has been using technology to improve those outcomes with the Detroit Young Adult Asthma Project. Funded by a series of National Institutes of Health grants, MacDonell began the project over 10 years ago by interviewing young African-American Detroiters about their asthma. She asked participants what strategies would help them adhere to their medication before an emergency arose. "Long story short, they wanted something using technology – something they could have with them, something easy to manage, something brief," she says. MacDonell developed a text messaging program that collects information about a patient's asthma and then sends the patient conversational messages encouraging medication use.
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How technology is bridging gaps between healthcare and underserved populations

Steven Ondersma discovered that "only a very small proportion, maybe 10 percent" of the people who need professional care realize that need and have the means to address it. "I've just become really interested in having whole-population effects, rather than helping a few people who might be ready to make use of the treatment and have access to that treatment," says Ondersma, deputy director of the Merrill Palmer Skillman Institute at Wayne State University. Ondersma and others in Michigan who are interested in addressing the social determinants of health have increasingly turned to technology as an answer to that question. Weisong Shi, professor of computer science at Wayne State envisions the potential for technology to bring a doctor's office to those more remote patients. He proposes a vehicle, "just like an ice cream truck," that would allow people to get basic physical tests in their communities, with the results being transmitted back to a provider's office. "You can go to this rural area and ... run these checks without asking these people to drive about 50 miles away to go to a hospital to do this kind of test," Shi says. Asthma disproportionately affects African-Americans nationwide, but in Detroit the problem is particularly pronounced – and often an emergency situation. Karen MacDonell, associate professor in Wayne State’s School of Medicine, has been using technology to improve those outcomes with the Detroit Young Adult Asthma Project. Funded by a series of National Institutes of Health grants, MacDonell began the project over 10 years ago by interviewing young African-American Detroiters about their asthma. She asked participants what strategies would help them adhere to their medication before an emergency arose. "Long story short, they wanted something using technology – something they could have with them, something easy to manage, something brief," she says. MacDonell developed a text messaging program that collects information about a patient's asthma and then sends the patient conversational messages encouraging medication use.
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Age of fraud: are seniors more vulnerable to financial scams?

Scientists looking into age-related financial vulnerability are very interested in physical changes to the aging brain, the way eyesight and hearing can get less keen. In some cases, a new pattern of making mistakes with money may be a harbinger of cognitive bad things to come, the “first thing to go,” as it were. McGill University neuroscientist Nathan Spreng was able to track down 13 elderly scam victims and 13 others equivalent in age, gender and education who had successfully fended off a scam. Spreng’s research found the brains of the two groups were physically different. He noticed this thinning of the part of the brain called the “insula,” which, along with a lot of other things, may help us trigger our “spidey sense,” the hunch that can warn us away from dicey financial situations. Some experts are skeptical about practical applications of research like Spreng’s. Peter Lichtenberg, director of the Institute of Gerontology at Wayne State University, is not a neuroscientist but a psychologist who studies financial decision-making capacity. While he sees the brain scanning as promising, his experience tells him financial acumen and scam-spotting are really complex matters. “There is no one aging pattern,” Lichtenberg said. “You know, some older adults are as good as they were in their fifties and sixties. Others are showing a more significant decline.” Lichtenberg says he has data showing 20 percent of older people admit when they do talk about money with others, it’s out of loneliness. That is, people might engage with a scammer because they want to talk to someone, anyone.
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Wayne State to form new pediatrics group, work closely with Henry Ford pediatricians

Wayne State University School of Medicine announced Monday the formation of Wayne Pediatrics, a new clinical service group of the university's medical school, that is intended to replace its longtime pediatrics group, University Pediatricians, which has left Wayne State and signed an affiliation agreement with Central Michigan University. Under the proposal, Wayne Pediatrics would become the clinical arm of the 130-physician Wayne State department of pediatrics, many of whom are also affiliated with 280-member University Pediatricians. Wayne Pediatrics also is discussing a partnership with the pediatrics department of Henry Ford Medical Group that would provide a continuum of primary and specialty pediatric services, said Herman Gray, M.D., chair of the department of pediatrics at Wayne State medical school. Gray said the Henry Ford partnership would also focus on improving the health of children and such social determinants of health as lack of access to quality housing, healthy food and transportation. Last week, a larger affiliation fell through between Henry Ford and Wayne State over a split on the unfolding arrangement by the university board of governors. Both WSU President M. Roy Wilson, M.D., and HFHS CEO Wright Lassiter III said they looked forward to resuming master affiliation talks sometime in the future, but would continue to work together on existing academic and clinical collaborations. The formation of Wayne Pediatrics is expected to cause Wayne State faculty pediatricians, many whom also belong with University Pediatricians, to choose between Wayne State and Central Michigan for their faculty affiliation. University Pediatricians, which is now a private-practice group that is affiliated with DMC Children's Hospital of Michigan, recently signed an affiliation with Central Michigan. It is expected that the UP pediatricians will become full-time faculty members faculty members with the six-year-old Mt. Pleasant medical school.
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Addressing rural Michigan's high infant mortality and poor maternal health

Michigan’s rural areas have high infant mortality and poor maternal health, fueled in part by substance abuse, lack of access to healthy food, and dwindling birthing hospitals and OB-GYNs. The root causes may be different from those in Michigan's urban communities, but the results are the same: Michigan's African-American and American Indian babies are three times likelier than white babies to die in their first year of life. Addiction is one of the biggest challenges for Michigan's rural mothers and infants. In Michigan’s rural areas, more pregnant women smoke cigarettes and abuse opioids than pregnant women in urban areas. "Cigarettes are the most commonly used substance during pregnancy and are at least as powerful a contributor to infant mortality as any of the other substances," says Dr. Steven Ondersma, a professor in Wayne State University's departments of psychiatry and behavioral neurosciences and obstetrics and gynecology. 
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Med students learn empathy and skills in Detroit street care programs

The Michigan State Medical School's Detroit Street Care program and Wayne State University's Street Medicine Detroit are helping medical students see past stereotypes to build relationships between homeless people and medical professionals to improve their quality of care, put them in touch with other resources like housing, and overcome some of the structural problems that make being homeless in Detroit especially deadly. In the process, the students themselves are engaging in a form of back to basics medicine that puts patients first. These programs allow medical students to reach out to homeless people on the street, carrying backpacks with medicine and diagnostic equipment, as well as necessities like hats, gloves, and food. They also meet with patients at places like the Tumaini Center, working under the tutelage of other medical students, nurse practitioners and doctors. On the street, they go out with a "peer support specialist," a formerly homeless person who helps them approach people.  
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Carry on John Dingell's legacy by making health care more affordable

Theresa A. Hastert, assistant professor in the Department of Oncology at Wayne State University School of Medicine, wrote an op-ed about the need to make healthcare more affordable. Hastert points out: “While Medicare, Medicaid and the ACA have expanded Americans’ access to health insurance coverage, it is no secret that our system has serious problems, and many still have trouble accessing care.” “The most fitting tribute to the late John Dingell, is to continue his decades-long legacy of improving Americans’ health and access to health care. His 60-year career in the House of Representatives included involvement in the most significant health care legislation in our nation’s history, including presiding over the House of Representatives in 1965 when it passed Medicare and sitting next to President Barack Obama when he signed the Affordable Care Act (ACA) in 2010. 
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Improving Detroiters' health is focus of Wayne State summit

Residents of Wayne County are the unhealthiest of Michigan's 83 counties, according to a ranking by the Robert Wood Johnson Foundation. Bridging that disparity was the target of a Wednesday summit at Wayne State University. Participants suggested ways to promote healthy eating, behaviors and environments. But the focus was on disparities affecting Detroit’s population, including asthma, heart disease, diabetes and obesity. The university brought together leaders of corporations, health care systems,  community organizations, foundations, policymakers and academics.
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NSF award to provide new insights on how drinking water and public health systems interact

A research team at Wayne State University recently received a four-year, $1.57 million grant from the National Science Foundation (NSF) for its project, “Water and Health Infrastructure Resilience and Learning.” The award is part of a multi-institutional $2 million collaborative project funded under NSF’s Critical Resilient Interdependent Infrastructure Systems and Processes program.
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Wayne State offers counseling for Muslim women on campus

Wayne State University’s Counseling and Psychological Services (CAPS) is offering a new service to Muslim women on college campuses. The new group, which will meet weekly, aims to provide a place for women to identify and discuss the issues and struggles of being a Muslim woman on a college campus. Kaifa Alsoofy, a university counselor at Wayne State who came up with the idea for the group, said in her work as a counselor, she’s seen Muslim women face issues like identity struggles and family, cultural or religious expectations.
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Wayne State to host Opioid Awareness Day Sept. 18

The opioid epidemic has devastated families across the nation, prompting Wayne State University to host an informative day on Tuesday, Sept. 18 from noon to 5:30 p.m. to educate others about the misuse, abuse and consequences of opioids. Through this day-long event, the university aims to better understand the scope of this crisis and how it impacts the local community. All students, faculty, staff and community members who are interested in gaining insight on opioids are welcome.
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President Wilson discusses the new Mike Ilitch School of Business on Conversations with WSU

Mildred Gaddis sat down with Wayne State University President M. Roy Wilson, and Darrell Dawsey, director of community communications. Earlier this week, President Wilson joined with some of Detroit’s most important business leaders to announce the opening of the Mike Ilitch School of Business, which promises to be an incubator for some of Detroit’s sharpest minds and a boom for our local workforce. 
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Detroit woman builds village for neighborhood

"This is a part of Wayne State Medical School's social mission," said Dr. Jennifer Mendez, the medical school's director of co-curricular programs and assistant professor of internal medicine. "It is a way for our students to apply their classroom knowledge to real-life situations." The Wayne State students also formed an organization to support Auntie Na's this year after being inspired during volunteer efforts during the last school year. It includes about 20 members.