Effort addresses health, safety, crime concerns
By JULIE MINDA
ASCENSION HEALTH
When a neighborhood is on the brink of decline, people can either resign themselves to creeping blight or do something about it.
A four-year-old program from St. John Providence Health System of Warren, Mich., is rallying Detroit residents to fight back. It is involving neighbors in clean-up efforts and safe street initiatives that stem urban decay, said Detroit resident Patricia Bosch. She is the executive director of a Detroit-area community development corporation.
The effort is based on the public health principle that health, safety and the environment are intertwined and that communities must address all three factors in order to improve residents' lives and sense of agency and well-being.
During an Innovation Forum session at the June Catholic Health Assembly in Anaheim, Calif., Patricia Maryland, St. John Providence's president and chief executive, and Cynthia Taueg, its vice president of ambulatory and community health, will explain how the system is becoming a change agent in three neighborhoods in Detroit's lower eastside through Healthy Neighborhoods Detroit. The initiative is building a presence in each neighborhood and then rolling out programs that engage residents in bettering their community, with a focus on health, safety and the environment.
Targeted effort
Once a bustling and prosperous car-making city, Detroit in recent decades has hemorrhaged jobs, income and population as its manufacturing base has eroded. A Census Bureau American Community Survey estimated that in 2011 Detroit's unemployment rate was 29.3 percent; its median household income was $25,193; and 40.9 percent of people lived below the poverty level. As Catholic Health World went to press in mid-February, The New York Times reported the city of Detroit was on the brink of municipal bankruptcy.
St. John Providence can't revive the city on its own, but it is determined to engage in the revitalization challenge in select neighborhoods where its efforts can make a difference. "You need to focus on a small area," said Cassandra Jackson, program manager for St. John Providence's Healthy Neighborhoods Detroit.
The system identified neighborhoods where it could tie its efforts in with a preexisting anchor of support services and partner agencies. Each of the three areas St. John Providence is targeting once housed an acute care hospital that has since been transformed into a hub of outpatient health care providers and social service agencies. Two of the campuses were St. John Providence hospitals.
Its first area of focus is the Osborn neighborhood on Detroit's eastside, a 75-block neighborhood of more than 146,000 people. The predominantly African-American neighborhood has an average household income of more than $40,000 and more than a third of residents have had at least some college education or have attained a degree. Osborn has escaped the worst of the blight that other Detroit neighborhoods have suffered, but it has not gotten through unscathed, Taueg said. "This area traditionally has had a higher rate of home ownership as well as a number of block clubs and other organizations including active churches that have helped to mitigate some of the impact of the economic decline."
But, even so, there are still "pockets of desolation" in Osborn, Taueg said. Some parts of the working-class neighborhood are dotted with foreclosed and abandoned properties. Some streets are unsafe. The crime blotter attests to assaults, robberies, and the sale of illegal drugs. And, prior to the repurposing of the hospital as a hub for social services and health care, residents lacked sufficient access to primary care services.
St. John Providence contracted the Greater Detroit Area Health Council to analyze data on health, safety and crime and prioritize needs of the Osborn area.
It engaged Dynamis Advisors, a consulting firm,to ask hundreds of community leaders and agency heads knowledgeable about the Osborn area for their ideas on how best to meet thatneighborhood's needs. St. John Providence partnered with some social service agencies to conduct focus groups with community residents and learned that people wanted better access to health care and social services in the wake of the hospital closure, and they wanted a safer environment, including less crime and less blight. (The hospital conversion to a social service hub was happening as the St. John Providence initiative was rolling out, and the services were not well developed at the time of the assessment.)
A visible presence
Before launching programming, the health system established a presence in Osborn by opening a "command center" — the Health and Safety Center — at Connor Creek, the former hospital campus-turned-community-service-center.
St. John Providence then worked with local partners — including not-for-profit community agencies, social service providers, churches, block clubs and government agencies — to start four initiatives targeted to the concerns surfaced in the needs assessment:
Paid staff and volunteers, who are background-checked and then trained by the county's sheriff's office, make up the patrols. Unarmed, they drive or walk Osborn's streets, monitoring for suspicious activity. They radio in minor concerns to a dispatcher at the Health and Safety Center. For emergencies, the patrols call 911. Taueg said the patrols "are our eyes and ears — they serve as a deterrent, a quick response team."
The center holds quarterly presentations to neighborhood residents on topics that surfaced as concerns in the assessment data or that residents have asked about. One seminar was on cybercrime. Another was on fire safety.
And to improve health literacy, the center holds seminars on health topics including health disparity and wellness promotion. Center staff also can point residents toward health care and social service providers that serve low-income people and the uninsured, including services offered at the Conner Creek health and social service hub.
The Health and Safety Center and its partners organize cleanup days with paid maintenance staff and neighborhood volunteers, to beautify common areas, abandoned lots and other properties overgrown with plants and trash. Bosch said crews have disposed of discarded tires, animal carcasses and furniture infested with bed bugs.
St. John Providence is conducting needs assessments in the other two target communities — neighborhoods surrounding the Riverview Center and Samaritan Center former hospital campuses. It will approach program development in a manner similar to the one that is proving successful in Osborn.
Interconnected issues
Jackson said the health and safety center is having a measurable impact on quality of life in Osborn. For instance, statistics show that since the center began its programming, there has been a reduction in sexual assaults and robberies in the neighborhood.
Taueg and Jackson said the approach touches multiple, interconnected aspects of community life that have a tremendous bearing on residents' well-being. Referring to research commissioned by the Robert Wood Johnson Foundation, Taueg explained that the neighborhoods where people live shape their behaviors and influence their health, including their mortality, mental health and whether they have chronic conditions. For instance, if people live in a crime-ridden area, they will not want to get outside and exercise.
Bosch said she thinks people in the neighborhood increasingly understand that connection, and they are getting more engaged in trying to improve their community. "Before, people felt overwhelmed and didn't try to address the problems in the neighborhood. But now they can see (the changes the center is initiating), and they want to be involved themselves."
Bosch said residents are calling the Health and Safety Center to report unkempt properties, parents are working with their schools to establish safe walking routes for students and businesses are cleaning up their properties.
She hadn't seen such engagement before. "What I see now is a sense of hope," she said. "People used to look to others to solve the problems, but now people are taking the initiative on their own."
Copyright © 2013 by the Catholic Health Association of the United States
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