This article was written as part of The Michigan Daily’s investigation into the current state and future of health equity in Michigan. Read other stories from the project here.
Health disparities are pronounced across Michigan, from the heightened COVID-19 mortality rates that Black Michiganders faced at the start of the pandemic to higher melanoma mortality rates in rural areas. The Michigan Daily spoke with leaders from three Michigan health care systems about what they are doing to advance health equity within the state.
Dr. Sharon O’Leary serves as Trinity Health Michigan’s first chief health equity officer. Trinity Health Michigan is part of the national nonprofit Catholic system Trinity Health and has nine hospitals located across the state, in addition to numerous primary and urgent care centers. Trinity Health, like many other health care systems in Michigan, has implemented efforts to address health inequity.
According to O’Leary, collecting and analyzing “REAL data” — or data on race, ethnicity, and language — is a key component of Trinity’s strategy for understanding health disparities.
“So because we have and we’ve validated that REAL data, we are able to take our clinical dashboards or operational dashboards and sort or disaggregate according to race and ethnicity,” O’Leary said. “And so that’s where we are going to see those disparities.”
In addition to REAL data, Trinity collects other information that might contribute to health disparities, like sexual orientation, gender identity and ZIP code. O’Leary said this data can then be used to help identify and address sources of health disparities within the clinical setting.
“If those outcomes are different, we may see that we aren’t providing equitable care,” O’Leary said. “And that’s the work of within the hospital, within our medical practices, our imaging centers, that’s the work of the hospital. If if you break out health equity, about 20% of it is caused by health care inequities, the care that we are providing.”
Similar data collection efforts are in progress at Bronson Healthcare Group, which has hospitals and outpatient services on the southwestern side of the state. Dr. Aaron Davies, interim chief clinical officer for Bronson Medical Group, said Bronson has patients self-identify for factors like race and ethnicity, preferred language, sexuality and gender identity.
“The gold standard is really self-report,” Davies said. “Our race and ethnicity is a social construct and is best determined by the person, because it reflects their identity. So we’ve worked really hard over the last five years to shift our data collection to self-report.”
One way Bronson has been addressing health disparities is through the Patients in Need Fund program, which provides financial support to cover costs associated with prescriptions, transportation to and from the hospital, medical equipment and home health care needs. According to Davies, the program is an equity-based initiative.
“It really creates that bridge from a state of resource deficit to hopefully a more stable set of resources,” Davies said. “The Patient in Need Fund allows us to do that in a way that, again, helps people not be in the hospital, not be in higher acute settings because we’re meeting the needs that they have.”
Bronson is also involved with a partnership with Cradle Kalamazoo, a health equity initiative that aims to mitigate infant mortality disparities in Kalamazoo County, where Black infants have significantly higher mortality rates than their white counterparts.
Cradle Kalamazoo aims to reduce infant mortality through both research and interventions, such as promoting safe sleep and offering family support programs. According to Davies, understanding social determinants of health is foundational to addressing disparities in infant mortality.
“If we’re going to be successful in closing the gap, each of us needs to individually understand the role of social drivers … (and) the impact of systemic and structural racism on health outcomes for people in our community,” Davies said. “I believe that we will get there eventually. It’s just when we see those disparities impacting people in our communities, we have a moral imperative to accelerate that closure.”
Henry Ford Health, which has locations throughout southeast Michigan, also has a program designed to address maternal and infant health disparities. The Women-Inspired Neighborhood Network: Detroit is a component of the Detroit Infant Mortality Task Force, which was formed in 2008 by four Detroit health systems, including Henry Ford Health and Detroit Medical Center. The WIN Network aims to support pregnant people by working with certified nurse midwives and community health workers to facilitate prenatal care groups and connect people with resources. In an interview with The Daily, Jaye Clement, director of community health programming and strategy at Henry Ford, said the program’s impact can already be seen among its first two cohorts.
“When we compare the participants in the WIN network to the city of Detroit, these numbers have much lower preterm deliveries, much fewer low birth weight deliveries,” Clement said. “We have more women and men initiate breastfeeding, we have less NICU usage, and when children do go to the NICU, they tend to have a much shorter stay in the NICU.”
Henry Ford Health also promotes health equity through a Community Information Exchange program with United Way and community food pantries. Clement said the program allows health care providers to connect patients with services that will help meet their needs and follow up to determine if the resources were helpful.
“We started with a pilot around food and the aging populations in a very specific geography, geography downriver,” Clement said. “We hope that it will also lend itself to equity, because we’ll be able to identify the people who are vulnerable because they have these gaps in their social needs and address them.”
Clement said advancing health equity is a core component of Henry Ford Health’s mission and that the system puts a health equity lens on all their programs.
“Our overall approach is to try to find a pathway to improving equity in everything that we do,” Clement said. “It is baked into who we are, (it) is a part of our culture.”
Daily News Editor Nadia Taeckens can be reached at taeckens@umich.edu.