Population Health Blog

Population Health Blog

Why It Matters

Community benefit agreements create legally binding ways of building community partnerships

By Dennis Archambault

In 2008, the Pittsburgh Penguins and representatives of several community organizations, negotiated the city’s first community benefit agreement that allowed for the construction a new hockey arena — Consol Energy Center — in the Hill District, in exchange for a much-needed quality grocery store, community center, and neighborhood partnership program, and job guarantees. The agreement resulted in more than $8 million in community reinvestment and considerable good will between the sports team and the city.

By contrast, Olympia Development of Michigan will build a new hockey arena financed through $450 in bonds. The development will ultimately include an entertainment district covering around 40 blocks immediately north of the Downtown business district. There was no community benefit agreement, other than a verbal commitment by the developer to assure hiring local workers.

Roderick Miller, president of Detroit Economic Growth Corporation, told the Detroit Free Press earlier this year that community benefit agreements add a later of bureaucracy to an already complex development process requiring developers to deal with “autonomous groups not responsible to anybody.”

Michigan House Bill 4052, introduced in May by Rep. Earl Poleski, would ban creation of community benefit agreements and ordinances, specifically referencing contracts that regulate employment policies involved with the development.

Jonathan Heller, co-founder of Human Impact Partners and keynote speaker for the 2015 Population Health Forum in Detroit, noted that community benefit agreements are useful tools for achieving a favorable exchange between massive developments that invariably benefit from public investment and the immediate community hosting the development. Often developments occur in low income areas — or areas that have long been neglected, like Detroit’s Cass Corridor where the Detroit Red Wings hockey arena is being built.

Community benefit agreements are more than “entitlements,” for local contractors and workers, as Michael Finney, head of Michigan Economic Development Corporation, referred to them in the Detroit Free Press. They are legally bind agreements for assuring social equity for communities affected by development that involves tax incentives, tax abatements, and public land.

In some respects, opposition over community benefit agreements will make efforts to implement health in all policies that much more difficult. Developers are likely to echo Roderick Miller in that health impact assessments add “a layer of bureaucracy to an already complex development process.” That’s only if you disregard the principal of social equity.

Free market advocates are likely to oppose anything that hinders their efforts to make a profitable deal. Every regulatory element adds time, and often cost, to their project. In some cases, they may conclude that the project isn’t worth the cost.

Economic development is integral to a healthy community. Communities have the right to determine if economic development is detrimental to the its health — even to the point of losing the development. In cities like Detroit, that may seem like economic suicide.

Of course, in business, Latin still has relevance: quid pro quo.  You sometimes have to give something to get something; and sometimes, you discover opportunity along the way.

The Pittsburgh Penguins got what they wanted and so did their city. Arguably, both are better off for it. The $8 million spent in developing the grocery store, community center, neighborhood partnership program firmly established the “Consol Energy Center” as a “catalyst in the revitalization of the community.” Appropriately, it won honors as the first National Hockey League arena to achieve LEED Gold certification through its conservation of materials, sustainability, and environmental quality.

Dennis Archambault is director of Public Affairs for Authority Health.

Modern midwifery seen through the historic lens of ‘Call the Midwife’

By Katie Moriarty PhD, CNM, CAFCI

Reflecting on the International Day of the Midwife, which was commemorated on May 5, it occurred to me that “Call the Midwife,” the outstanding PBS series, has done a great job to project the role of midwifery in maternal public health through a historic context. Our weekly visits to the East End of London calls to mind areas of Detroit, Inkster, and other low income communities in our region. The universal truth of midwifery is as evident in this series as it is in the work of modern midwives, hence our blog, “Call the Modern Midwife,” which is a companion to the PBS series.

Thank you to Call the Midwife for showcasing the lives that midwives lead and depicting the fantastic stories of happiness, heartbreak, faith, and friendship that come along with being in this amazing profession!  I have often said that being a midwife is really a calling more than a profession and each week as I follow the episodes that perception is further solidified.

Birth is a common miracle. It is an honor to bear witness as it unfolds.  As midwives, we try to empower women through this life event and enter their lives in real and tangible ways.  Whenever I hear that someone has had a baby—my mind always drifts to wanting to know their birth story.  Everyone gets to this world through their own unique birth story, whether it is known to them or not.  As a midwife we like for our births to be ‘uncomplicated’—but that is not always the case.  So hats off to all the midwives in the world—we get to walk this path with women and we can almost always be guaranteed a raw, intimate, and exhilarating day (or night).

International Day of the Midwife offers us a chance to reflect on all the women who have served as midwives in the past, those who are called to this service today, and those who are preparing to walk this path in the future—and therein lies the unbelievable power.

Katie Moriarty PhD., CNM, CAFCI, is director of the Detroit Nurse-Family Partnership and a contributing writer for the blog, Call the Modern Midwife, a companion to the PBS series Call the Midwife.


Black Lives Matter; We can’t stay on the sidelines

By Jonathan Heller

Let’s not sit on the sidelines.

With those words Dr. Mary Bassett, health commissioner of New York City, in a Perspective for The New England Journal of Medicine clearly and boldly declares that health professionals are accountable for fighting interpersonal and institutional racism, because of the undeniable truth that racism contributes to poor health outcomes.

In “#BlackLivesMatter: A Challenge to the Medical and Public Health Communities,” Dr. Bassett acknowledges that “tackling racism is daunting” and for many in the health community “often viewed as divisive and requiring action outside our purview.” She calls out the “dearth of critical thinking and writing on racism and health in mainstream medical journals,” pointing out that over the last decade only 14 articles in NEJM even contained the word racism. And she lists three ways we can – and should – make a difference:

  • Research: “By studying ways in which racial inequality, alone and in combination with other forms of social inequality (such as those based on class, gender, or sexual preference), harms health, researchers can spur discussions about responsibility and accountability. Who is responsible for poor health outcomes, and how can we change those outcomes?”
  • Internal reform: “Our target ‘high-risk’ communities, often communities of color, have assets and knowledge; by heeding their beliefs and perspectives and hiring staff from within those communities, we can be more confident that we are promoting the right policies.”
  • Advocacy: “Some [health professionals] may choose to participate in peaceful demonstrations; some may write editorials or lead ‘teach-ins’; others may engage their representatives to demand change in law, policy, and practice.”

Right on! These actions align completely with HIP’s new strategic direction – research, advocacy, and capacity building to bring the power of public health science to campaigns and movements for a just society. They also align with the work members of our Public Health and Equity Cohort are doing to advance racial and other forms of equity in their health agencies and communities, with an inside-outside strategy for change. And they reflect the way we do our work at HIP and what we advocate that other health professionals should do in their work.

Dr. Bassett is right. Addressing structural racism is hard. But we can’t sit this struggle out. Let’s remember why we’re in this: to improve health and reduce health inequities. We can’t back off when that means we must confront racism.

Jonathan Heller is co-founder of Human Impact Partners. See more at: http://www.humanimpact.org/author/jonathan/#sthash.3kTgMa3O.dpuf