Population Health Blog

Population Health Blog

Why It Matters

Suburban ‘pockets of poverty’ create new challenge for population health

By Dennis Archambault

Canton, Livonia, Dearborn — you might not think of these suburbs as having residents who are impoverished. It’s been well-known since the last major recession and the collapse of the manufacturing center that employment was slow to recover and many households are struggling nearly a decade later. That struggle translates into critical social determinants that erode access to health and health status overall.

Crain’s Detroit Business asked the question about the role of philanthropy in addressing “poverty quietly growing in the suburbs” (http://www.crainsdetroit.com/article/20171022/news/642721/suburban-poverty-on-the-rise-but-is-philanthropy-following). It might have asked the same about the public and private health system. Community needs assessments are noting these growing pockets of poverty, as are other initiatives like Healthy Dearborn, which has noted areas of food insecurity in that community, which has access to quality produce markets in almost ever sector of its geography.

Poverty is no longer geographically centered in urban centers like Detroit or its working class suburbs like Ecorse, River Rouge, and Inkster. In many cases its invisible, such as the homes of some refugee families that have no furniture. “Low-wage jobs, older housing stock that is less desirable and less expensive and drawing lower-income populations and the loss of jobs tied to the shift from a manufacturing economy are spurring the growth of poverty,” notes Alan Berube, senior fellow at the Brookings Institution.

There certainly is a role for philanthropy. But this is also a growing public health challenge that needs to integrate the resources of the private health system. The Crain’s article suggests that suburban poverty tends to grow, it doesn’t recede, but may be ignored. Health issues driven by the social determinants of poverty affect the neighbors of more affluent people as it does larger communities.

“Detroit is not an island,” notes Tonya Allen, CEO of the Skillman Foundation.

Dennis Archambault is vice president, Public Affairs for Authority Health.

Enduring the culture of crime: calling for resilience

By Dennis Archambault
It’s nothing new; certainly not for communities like Detroit that have been living with high crime rates for decades. You get by or get out. You cope.

The Detroit News is running a series of stories under the categorical heading of “coping with crime.” What is often misunderstood with the focus on statistics – whether or not they are accurate and whether or not Detroit is the number one crime city or somewhere near the top – is that there is a residual erosion of wellness in the community impacted by the knowledge of people who have been victimized and the fear that permeates the culture.
The city has an average of six killings a week, not to mention property crimes. The cumulative effect of knowing this through anecdotes that is near as a neighbor affects people. Even though thousands of Detroiters may not be affected by crime, they are affected by living in a culture of crime and the awareness that it’s happening and could happen to them. This makes you sick, mentally and physically. It diminishes the will to exercise outdoors. It encourages you to eat comfort food which is likely to be detrimental to your health.

Coleen Farm, also with Mothers of Murdered Children, said she’s had a tough time recovering after the fatal drive-by shooting of her son Don Adams Jr. on July 24, 2012.

“It was really overwhelming to deal with,” she said. “I had a major weight loss, sleepless nights. I was edgy — I would go from zero to 100 in two seconds. I would sleep all day. I didn’t want to be bothered with my other children, my family members. I was crying continuously.”

The resilience movement is designed to empower communities to get beyond enduring a crime-ridden culture to creating a community of caring. Impoverished areas enduring a culture of crime and violence can’t sleep well; can’t eat well; can’t learn. Sure, some will overcome and thrive. The social Darwinians would call them among the fittest; the others must fend for themselves. But the ethic of population health suggests that we have a social responsibility to lift all for the greater good.


Dennis Archambault is vice president, Public Affairs, for Authority Health