MEMORANDUM

TO: Ali Makki, Supriya Gupta, and Raveena Mata

CC: Andrew Cavin

FROM: Yousuf Zafar

DATE: February 1, 2017

SUBJECT: Chronological patterns of public health in Detroit

Within the context of our groups overarching problem of public health in Detroit, I will
be addressing the history and chronology of the problem, particularly on the institutional
level. Furthermore, I will discuss the economic consequences of the historic changes in
the health care institutions of Detroit, as well as the potential consequences that equality
of access to health care can have on the population. Finally, I will conclude with
proposed solutions to these issues where I could find solutions and how we may go about
implementing these solutions.

In the initial stages of Detroits history, the Health Department was run by the city itself,
which meant that health care was available to all Detroiters insured or uninsured. The
institutions began to grow, until a group of three doctors in 1872 eventually turned into a
Receiving Hospital (then referred to as the Detroit General Hospital (DGH)), a Herman
Keifer Hospital, a Maybury Sanitorium, a Redford Emergency Branch, the City
Physicians Service which provided 36,007 home visits in 1953, five district health
centers, and school dental clinics. One benefit of this institutional growth was the
availability and creation of jobs in the public sector, as one journalist notes, [M]any
Black doctors, nurses and other workers were employed at DGH, the Health Department,
and other city departments (Bukowski). Another benefit was that health care was
accessible to the citizens of Detroit with relatively little difficulty.

However, these public institutions began to be privatized, thus no longer remaining under
the umbrella of the city, until the last remaining public hospital, the DGH, was privatized
by the DMC around 1980. The result of privatizing health care was that both of the
aforementioned benefits were taken away. As for the first benefit of job creation,
Detroits economy crashed since the privatization of the DGH meant the loss of public
employees - in addition to the loss of autoworkers cause by the shutdown of Dodge Main.
As for the second benefit, Detroiters now had limited access to health care since they had
to be insured and thus access to health care became much more expensive. The for-profit
DMC still exists today, and private corporations and companies continue to accumulate
profits in spite of the poverty of the population. As a result, Detroiters today are no longer
receiving the health care that they need.

There are many potential solutions to the root problems that cause unequal access to
health care in Detroit. Firstly, as a principle, we must be proactive rather than reactive. In

Yousuf Zafar | fz7319@wayne.edu

practicality, that translates to limiting the potential health risks that people can be exposed
to and working to prevent illnesses from occurring and spreading. A resident student at
Wayne State (who preferred to remain anonymous) also expressed this same sentiment in
an interview, in which we asked him a few questions about the food situation on campus.
The interview is reproduced below.

Q. Where do u usually eat on campus?

A. Gold and Greens.

Q. Do you feel that you have access to adequate, healthy food?

A. Yes, the dining hall provides a myriad of options. Healthy choices are readily
available, including fruits, vegetables, etc. Also, Gold n Greens is vegetarian, so healthy
options are varied.

Q. What could Wayne State do to improve the food situation on campus and the health of
their students?

A. While wayne.campusdish.com does allow for calculating the nutritional content of

foods, it is generally not a publicized resource. In order to help residents make more
informed decisions regarding their meals, educating them about this and other resources
could help.

Q. How do you feel about the recent incident at Towers Cafe of students potentially being
exposed to Chickenpox?

A. I feel that the Towers Cafe incident is a reminder that, despite precautions, health can
still be compromised. I was gladdened by WSU's serious response to the issue and how it
made multiple resources available to those seeking help in that regard.

Q. What measures could we take to prevent such incidents from occurring in the future?

A. I believe that standard precautions to minimize the spread of disease are crucial for
this. Enforcing strict hygiene for employees and encouraging residents to be mindful of
their hygiene and health (ex. hand sanitizer) would probably have a major impact. These
preventative measures are infinitely cheaper and easier to maintain than measures taken
after disease spreads. However, it would also be good to bolster the response measures
currently in place to address the spread of disease, so that it can be quickly detected and
suppressed.

One example of prophylactic health care that the student mentioned is encouraging
students to be mindful about hygiene and health, such as through the use of hand
sanitizer. Another example would be to increase awareness about products that can be
harmful to a persons health, such as the growing trend of e-cigarettes. Along the same
lines, Surgeon General Vivek Murthy expressed his main concern that e-cigarettes have

Yousuf Zafar | fz7319@wayne.edu

the potential to create a whole new generation of kids who are addicted to nicotine. He
further notes, If that leads to the use of other tobacco-related products, then we are going
to be moving backward instead of forward (Neergaard).

While these are notable examples of personal preventive care, research suggests that
other, apparently non-health related factors do in fact have an affect on a persons
chances of suffering from chronic illness or functional limitations. For example, strong
social relationships with ones children and grandchildren among Detroiters was linked to
significant health benefits (Ajrouch). Although social relationships may not seem to be
directly related to public health, it is an avenue through which preventive care may be
implemented, especially when health care has been privatized so extensively. The director
of public health in Detroit, Dr. Abdul El-Sayed, also reflects the same idea when he
states, The question is how do we improve and bolster the maternal and child health
work but, at the same time, support people ... who are at risk or may suffer chronic
diseases like obesity, diabetes, cardiovascular disease, cancer (Helms). Lastly, a major
niche of preventive care that we should focus on is promoting healthy diets, which Wayne
State seems to have started doing already according to our interviewee; our job is to
spread the awareness beyond the college campus.

Yousuf Zafar | fz7319@wayne.edu

 Bibliography

Ajrouch, Kristine J. "Health Disparities and Arab-American Elders: Does

Intergenerational Support Buffer the Inequality--Health Link?" Journal of Social

Issues 63.4 (2007): 745-58. ProQuest. Web. 1 Feb. 2017.

Bukowski, Diane. "DETROIT FOUNDED HEALTH DEPT. IN 1825; IT PREVIOUSLY

RAN 3 HOSPITALS INCLUDING DETROIT GENERAL, 5 CLINICS,

PHYSICIAN HOME VISIT SERVICES." VOICE OF DETROIT: The City's

Independent Newspaper, Unbossed and Unbought. 21 May 2012. Web. 01 Feb.

2017.

Helms, Matt. "Detroit's New Public Health Director Aims to Innovate." Detroit Free

Press. 25 Nov. 2015. Web. 01 Feb. 2017.

Neergaard, Lauran. "Surgeon General: Youth Vaping a Public Health Threat." Detroit

News. 08 Dec. 2016. Web. 01 Feb. 2017.

Yousuf Zafar | fz7319@wayne.edu