Social Determinants of Health
All of HEP's programs and projects are related to addressing social determinants of health in the city of Detroit.
One of our earliest initiatives that focused on this complex issue was called Social and Physical Environments and Health Disparities -SPEHD, 2000-2005, (R01 ES10936). This five-year initiative, funded by the National Institute of Environmental Health Sciences (NIEHS), examined multiple aspects of social and physical environments, including the built environment, infrastructure, social environments and air quality, and their relationships to health inequities in Detroit.
Findings from this study demonstrated, for example, that: inequities in food access across areas of Detroit are linked to dietary practices; the condition of the built environment (e.g., sidewalk condition) is associated with physical activity of residents; air pollutants impact blood pressure, with the strongest effects documented among residents of Southwest Detroit; and effects of poverty on cardiovascular risk were explained in part by stressful neighborhood conditions.
Subsequently, HEP built on the SPEHD project through Lean and Green in Motown (LGM, 2005-2010, 5R01ES14234-3), a five year study designed specifically to examine additional aspects of the built environment and their implications for physical activity, dietary practices and obesity as a major risk factor for cardiovascular disease. This NIEHS-funded study further documented associations between characteristics of the city's infrastructure (e.g. street connectivity) and physical activity, and allowed analysis of change over time in critical social determinants of health in the city.
More recently, in a series of conversations facilitated by U-M SPH Assistant Professor Roshanak Mehdipanah, and using the World Health Organization’s Urban Health Equity Assessment and Response Tool (Urban HEART), HEP has identified key indicators of urban health equity relevant to Detroit across five domains: physical environment and infrastructure, social and human development, economic opportunity, governance, and general population health. The Urban HEART tool has been used successfully to identify key indicators of underlying determinants of health equity in 100 cities in 53 countries. As the first U.S. city to implement this process, HEP and Detroit continue to play leadership roles in emergent national conversations about the role of social determinants in shaping health equity.
Please visit the Publications page to learn more about HEP’s research on this important issue. Relevant studies include: Ball et. al. 2015; LeBron et. al. 2015; Geronimus et. al. 2015; Schulz et. al. 2013; Schulz et. al. 2012.