When the Ford Motor Co. debuted the Model T in 1908, it not only revolutionized the automotive industry, but it also jump-started the city of Detroit. Henry Ford watched the city’s population boom as the company’s workforce grew, and with that rise came an increase in health care needs.
The car mogul recognized the need to keep the growing community healthy, and the following year he chaired a group working to build a new Detroit hospital. In 1915, Henry Ford Hospital opened its doors to aid the Detroit community. Now, 105 years later, the Henry Ford Health System still has the same focus: improving the health and well-being of the people of Detroit and surrounding counties.
“At Henry Ford, we are always looking for better approaches to solve problems in ways that are inclusive and thoughtful about our community members,” said Kimberlydawn Wisdom, MD, MS, senior vice president of community health and equity, and also the chief wellness and diversity officer for the Henry Ford Health System. “Our leadership embraces innovation, following a long tradition, and that’s what’s so exciting about working at Henry Ford.”
For Henry Ford Health System, one of the nation's leading health care providers, innovation is a core competency or “part of our DNA.” It also takes pride in embracing diversity & inclusion and providing a place for everyone to be who they are, with a common purpose in servicing patients. Dr. Wisdom is one of six AMA members recognized for their work as health care innovators.
That innovation has been on display this year as Henry Ford—like the rest of the country—grapples with the novel coronavirus.
“COVID-19 has illuminated many of the challenges that we knew existed related to health inequities, disparities and social injustice,” Dr. Wisdom said. “They’ve existed for a long time, but—except for those people that were pretty committed to this space—there wasn’t the intensity of focus that exists currently.”
Detroit’s health challenges
When it comes to care for the community, one of the primary goals at Henry Ford—an AMA Health System Program Partner—is to mitigate social needs, such as limited access to food, housing instability, transportation needs, and interpersonal violence and identify ways to partner to address social determinants of health (SDOH).
The 2018 Detroit Community Health Needs Assessment reported that Detroit has the highest percentage of poverty in any major U.S. city, with a number of data points demonstrating how the community’s health lags behind Michigan’s state average. For example:
- Nearly 30% of Detroiters feel their health is “fair or poor.” The state average is 18%.
- The average life expectancy in Michigan is 78 years, while nearly every Detroit neighborhood’s average is lower.
- The infant mortality rate in Detroit is 14 per 1,000 live births. Michigan’s infant mortality rate is 7 per 1,000 live births.
There are a number of factors that contribute to these sobering statistics, including a variety of social determinants. A common misunderstanding with SDOH is that vulnerable populations only face one at any given time, Dr. Wisdom said. A family may have unmet transportation needs because they can’t afford a car and live two miles from the closest bus stop, and that can lead to food insecurity because the closest grocery store is three miles away in the opposite direction.
“Many times, social needs are complex and multifactorial,” she said. “It isn’t like a person has one need only and if you fix that one need, then they’ll be able to function well, adding to their overall health and wellbeing.”
A free online education module, “Health Disparities: Social Determinants of Health,” offered via the AMA Ed Hub™, helps medical students and physicians grasp how these factors affect a patient’s health, how to ask patients the right questions about them, and how to help improve health outcomes and health equity for all patients.
Stretching the food budget in a healthy way
Dr. Wisdom has a unique perspective on SDOH. In 2003 she became the nation’s first state-level surgeon general, and for eight years she met with thousands of Michiganders to hear about their health needs as she worked to rebuild the public health system and build collaborative partnerships.
Dr. Wisdom has worked with her Henry Ford colleagues to launch a variety of initiatives that help address Detroit’s most pressing needs. Some of the programs are singularly focused, while others take a more comprehensive approach to addressing SDOH.
For example, Dr. Wisdom founded Generation With Promise (GWP) focused on policy, environmental and behavioral change to help make food more accessible to at-risk populations while equipping participants with skills needed to make healthy changes at home, school, or within the community.
GWP provides nutrition education and features cooking classes for participants in schools, senior centers, and community organizations to demonstrate how to prepare healthy meals for four to six people for less than $10. The program also shares information about how to affordably access fresh, locally-grown produce that in the process benefits the state’s small and midsize farmers.
“We not only teach how to cook on a budget in a healthy way,” Dr. Wisdom said, “but we also teach families how to stretch their budget in order to maximize their ability to feed their families.”
With the arrival of COVID-19, Henry Ford Health System showed its innovative prowess by launching At Your Door: Food & More. This program built on the success of GWP and featured contact-free deliveries of food boxes, as well as nutrition information, recipes and access to virtual chef-led events.
Read more about the lessons Henry Ford’s leaders have learned as they prepare for a potential COVID-19 surge this fall and winter.
Helping moms have better births
While GWP tackles a specific health determinant, the Women-Inspired Neighborhood (WIN) Network: Detroit takes a more wide-ranging approach as it seeks to cut Detroit’s infant mortality rate. WIN facilitates better coordination among agencies and programs to help provide care and support to at-risk women in order to achieve healthier pregnancies.
A team of patient-advocate Community Health Workers (CHW) and certified nurse practitioners co-facilitate group meetings with women near the same gestational stage. In between meetings, the CHWs visit the women in their homes or neighborhoods and help address their circumstances, be it housing or interpersonal challenges.
“The involvement of CHWs is a game-changer. They’re the secret sauce,” Dr. Wisdom said. “They visit the home between clinic group visits. They build trust. They’re the ones who can address more comprehensively the social needs that these families have.”
Learn more about how community health workers can help improve outcomes and cut costs.
Since WIN launched in 2012, the effort has helped over 500 women deliver babies. The children born are full-term, weigh about seven pounds and almost all successfully initiate breastfeeding.
The impact of WIN could have been weakened during the pandemic, but Henry Ford Health System again focused its attention on what the patients needed. Not only did WIN participants receive home deliveries of food, but they also were given medical equipment like blood pressure cuffs and scales to monitor their health. Henry Ford Health System leveraged telemedicine to allow WIN participants to communicate with physicians through virtual visits.
What makes WIN unique is that it was formed through a collaboration between Detroit’s four major health care systems and service agencies throughout the metropolitan area. It is that type of innovation that has become a hallmark at Henry Ford. And according to Dr. Wisdom, the notion of addressing a health issue by examining the medical and social needs together is the key component in addressing SDOH.
“We need to partner in a very deliberate, intentional, and systematic way with public health [departments], with our urban planners, and with our economic developers,” Dr. Wisdom said. “We need to partner in ways that traditionally we haven’t if we’re truly going to address social determinants of health.
“We have to engage partners that can truly change the environments so that people can ultimately be healthier.”
Learn more about how the Henry Ford Health System is moving medicine.
