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.

Arash Javanbakht, assistant professor of psychiatry, wrote a piece for The Conversation about the growing interest in trauma and childhood trauma. “A child’s brain is a sponge for learning about how the world works and who they themselves are. We humans have an evolutionary advantage in having the ability to trust the older and learn from them about the world. That leads to cumulative knowledge and protection against adversity, about which only the experienced know. A child absorbs the patterns of perceiving the world, relating to others and to the self by learning from adults. But when the initial environment is unusually tough and unfriendly, then a child’s perception of the world may form around violence, fear, lack of safety and sadness. Brains of adults who experience childhood adversity, or even poverty, are more prone to detecting danger, at the cost of ignoring the positive or neutral experiences.” Javanbakht continued: “Childhood trauma is more common than one would think: Up to two-thirds of children experience at least one traumatic event. These include serious medical illness or injury, firsthand experience of violence or sexual abuse or witnessing them, neglect, bullying and the newest addition to the list: mass shootings.

A client suffers from one of the oldest and most common fears: arachnophobia. The mere thought of a spider causes her anxiety, and she often has a friend check a room for spiders before she enters. She wants to get help, but she lives in a remote area without access to a clinical expert. Could the use of augmented reality help the client overcome this phobia and actually touch a tarantula? Arash Javanbakht, an assistant professor of psychiatry and director of the Stress, Trauma & Anxiety Research Clinic (STARC) at Wayne State University, has found that it can. At STARC, Javanbakht uses augmented reality along with telepsychiatry as a method of exposure therapy for clients with phobias.

“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.

Cystic fibrosis (CF) is a complex, life-threatening disease that affects many organs in the body, including the lungs, kidneys, and gastrointestinal tract. It’s caused by a genetic mutation that causes a certain protein to stop working. “The predominant way CF affects the body is in the gastrointestinal and respiratory system, but it causes a wide variety of complications that affects every system in the body,” Zubin Mukadam, M.D., assistant professor of pulmonary and critical care at Wayne State University, tells Health. “We do a lot of newborn screening,” says Mukadam. “However, a lot of kids get missed because there are over 1,700 genetic mutations that could prompt CF, and most genetic tests only screen for the most common mutations.” 

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.

Researchers in Wayne State University’s department of ophthalmology, visual, and anatomical sciences have discovered in experimental models that the Zika virus can cause glaucoma. The study was published in mSphere, a peer-reviewed journal of the American Society of Microbiology. Zika virus, or ZIKV poses challenges in reproductive health and has been shown to cause neurological disorders, primarily microcephaly, or the abnormal shrinking of the head circumference. Several clinical studies have also linked ZIKV to ocular deformities. “The eye is protected from systemic infection due the presence of a protective barrier called the blood retinal barrier,” says Ashok Kumar, associate professor and lead author of the study. “Previous studies from our laboratory have shown that ZIKV has the ability to infect and replicate in cells making the blood retinal barrier, hence potentially allowing the entry of ZIKV into the eye."

Vaibhav Diwadkar, professor of psychiatry, and Otto Muzik, professor of pediatrics and radiology wrote an article for The Conversation about how the body responds to cold exposure. “There are people who show incredible resistance to extremes of temperature. Think of Buddhist monks who can calmly withstand being draped in freezing towels or the so-called “Iceman” Wim Hof, who can remain submerged in ice water for long periods of time without trouble. These people tend to be viewed as superhuman or special in some way. If they truly are, then their feats are simply entertaining but irrelevant vaudevillian acts. What if they’re not freaks, though, but have trained their brains and bodies with self-modification techniques that give them cold resistance? Could anyone do the same? As two neuroscientists who have studied how the human brain responds to exposure to cold, we are intrigued by what happens in the brain during such resistance. Our research, and that of others, is beginning to suggest these kinds of “superpowers” may indeed result from systematically practicing techniques that modify one’s brain or body. These modifications may be relevant for behavioral and mental health, and can potentially be harnessed by anyone.”

Arash Javanbakht, assistant professor of psychiatry, wrote an article for The Conversation about post-traumatic stress disorder, or PTSD. “PTSD is common, affecting 8 percent of the U.S. population, up to 30 percent of the combat exposed veterans, and 30-80 percent of refugees and victims of torture. A brain scan is a general term that covers a diverse group of methods for imaging the brain. In psychiatric clinical practice, brain scans are mostly used to rule out visible brain lesions that may be causing psychiatric symptoms. However, in research we use them to learn about the pathologies of the brain in mental illness. 

Although it's still considered a rare cancer — comprising about 3 percent of all cancer cases — the incidence of pancreatic cancer has been steadily increasing for decades in the United States, according to the Centers for Disease Control and Prevention. The higher number of cases can be attributed to a few factors, said Dr. Philip Philip, vice president of medical affairs at the Barbara Ann Karmanos Cancer Center and professor of oncology and pharmacology at the Wayne State University School of Medicine.

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. 

Four Michigan universities have teamed up to develop a program offering upcoming medical graduates a $75,000 loan repayment to work in rural and urban underserved communities. Michigan Doctors, or MIDOC,  is a partnership between Wayne State University, Western Michigan University, Michigan State University and Central Michigan University. The program has developed select residency openings for graduating medical students. "There is fierce competition nationwide for a limited number of residency slots each year," said Jack D. Sobel, M.D., dean of the Wayne State University School of Medicine, in a statement. "We must find innovative ways to increase the number of resident training positions if we are to successfully meet the state and nation's growing needs for more physicians."

Arash Javanbakht, assistant professor of psychiatry, wrote an article about the murder of 50 people in New Zealand, which he described as “another tragic reminder of how humans are capable of heartlessly killing their own kind just based on what they believe, how they worship, and what race or nationality they belong to.” Javanbakht, a psychiatrist and neuroscientist specializing in fear and trauma, offers some evidence-based thoughts on how fear is abused in politics. 

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.  

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. 

In 2012, researchers published the results of a retrospective study looking at which candidates admitted to a otolaryngology residency program turned into the most successful clinicians as ranked by faculty. What they found was that those who got the highest faculty ratings were those with an “established excellence in a team sport.” While the researchers cautioned that not all residency program directors should rush to look for student-athletes, the study did isolate two traits of student-athletes that might translate into success in medicine: time management skills and teamwork. Indeed, it’s not specific athletic skills that matter, says M. Roy Wilson, M.D., president of Wayne State University and former chair of the AAMC Board of Directors, but the ability to juggle sport and academic responsibilities and excel at both. “Learning how to manage time efficiently is critical, and the main complaint that medical students have is just the volume of material they have to digest. So much of medicine is really about personality, or the ability to deal with people effectively and the ability to lead people. Those are characteristics we see in student-athletes who have been successful in team or individual sports.” 

Arash Javanbakht, assistant professor of psychiatry, wrote an article about dealing with life’s challenges that may instill fear and uncertainty in people. Javanbakht wrote: “As a psychiatrist specialized in anxiety and trauma, I often tell my patients and students that to understand how fear works in us, we have to see it in the context where it evolved. Ten thousand years ago, if another human frowned at us, chances were high one of us would be dead in a couple minutes. In the tribal life of our ancestors, if other tribe members did not like you, you would be dead, or exiled and dead. Biological evolution is very slow, but civilization, culture, society and technology evolve relatively fast. It takes around a million years for evolutionary change to happen in a species, and people have been around for about 200,000 years. 

Dr. David R. Rosenberg, professor and chair, Department of Psychiatry and Behavioral Neurosciences, psychiatrist in chief at Wayne State University and the Detroit Medical Center, wrote a letter to the editor. Our team at Wayne State University has developed innovative programs targeted at our most vulnerable and high-risk populations that both improve outcome and reduce cost. We have published these results in prestigious peer-reviewed journals demonstrating significant reductions in lengths of stays and repeat visits of behavioral patients in the ED, and a 94 percent reduction in inpatient psychiatric hospitalization from the ED.

Dr. David R. Rosenberg, professor and chair, Department of Psychiatry and Behavioral Neurosciences, psychiatrist in chief at Wayne State University and the Detroit Medical Center, wrote a letter to the editor. “As chair of the Department of Psychiatry and Behavioral Neurosciences at Wayne State University, I read and applaud the recent focus of Crain's on the growing behavioral health care crisis in our nation's emergency departments. Patients with serious emotional and behavioral problems in the emergency department remain the diagnostic and therapeutic orphans of the American health system. Sadly, in a system dominated by politics, posturing and "paying the bills," these patients are often short-changed. 

Corktown Health Center got $500,000 from the Michigan Health Endowment Fund to offer care and support for older LGBT adults. The Detroit health center is the first focused on LGBT health in Michigan, according to its website. The two-year grant will fund its Silver Rainbow Health Initiative, according to a news release. The program will be a collaborative effort between Corktown Health, SAGE Metro Detroit and the Wayne State University School of Medicine. SAGE Metro Detroit grew out of the LGBT Older Adult Coalition. It works to build awareness and change for elderly members of the LGBT community. The Corktown Health Center opened in 2017 in a renovated 24,000-square-foot facility at 1726 Howard St., aiming to alleviate a lack of LGBT-focused care in the area. It partnered with Wayne State University and the Wayne State University Physician Group late that year to increase its capacity and expand its resources. The health center's services include primary care, health insurance help, behavioral health, and comprehensive HIV care and treatment. Pharmacy services are coming soon, according to its website.