SPH in Detroit: Detroit’s Chronic Disease Challenge

Chronic Disease

More than half of the world's population lives with at least one chronic condition.

In places like Detroit, chronic diseases such as asthma and type 2 diabetes, which disproportionately affect urban minorities of lower socioeconomic status, pose a particular challenge. One way to confront this challenge is to improve people's lifestyle behaviors and support their efforts to self-manage chronic conditions after diagnosis.

Scientists in the U-M Center for Managing Chronic Disease (CMCD) are working to do just that—improve chronic-illness care by supporting people with, and at risk for, diabetes and other conditions. By better understanding the social, behavioral, environmental, and clinical factors that underpin chronic disease, researchers hope to facilitate behavioral changes that can improve health outcomes, increase quality of life, and decrease costly health-service use—around the world and here at home, in Detroit.

Asthma

Older adults with asthma are often overlooked by researchers focused on the epidemic of asthma among children and adolescents. To address this issue, lead investigator and SPH Assistant Professor Alan Baptist and his team are studying the effects of an asthma self-management intervention to help adults over age 40 prevent acute, and possibly life-threatening, episodes.

Under the direction of Randy Brown, director of asthma programs, a CMCD team is wrapping up two asthma clinical trials: Women Breathe Free, a study to test the efficacy of a telephone-based asthma self-management intervention for African-American women; and PACE Plus, a study to determine whether a physician-training program based on cultural competency improves asthma management and symptoms in low-income African-American and Latino children.

Diabetes

CMCD researcher Laurie Lachance is partnering with the National Kidney Foundation of Michigan to evaluate programs aimed at reducing diabetes-related disparities in vulnerable communities in northwest Detroit. Her research team is tracking efforts to change local policy and infrastructure, interviewing key informants, and assessing the impact of local coalitions.

Developed by CMCD Director John Piette, the CarePartner program is designed to test the effectiveness of a year-long automated telemonitoring intervention, which provides weekly updates to participants on their diabetes status and self-management efforts. The intervention includes a family-caregiver program.

One of eight nationwide sites funded by a Safety-Net Enhancement Initiative (SNEI) grant from the Kresge Foundation, IMPACT, a Healthy Living Campus located in Detroit's St. John Conner Creek Village, aims to reduce diabetes and hypertension by providing a safe, central location for services and activities. Laurie Lachance is leading efforts to evaluate the initiative, which supports community-based projects to address the social determinants of health. To date, the Detroit SNEI has worked to transform physical infrastructure, create system and organizational changes, and develop a social network around health.

Health Disparities

In collaboration with the Kellogg Foundation's Food & Fitness community partnerships, which seek to inform communities about tangible improvements to food access, Laurie Lachance and her research team are partnering with Detroit communities to assess the efficacy of local policy and system changes to the food system.

Mental Health

Spearheaded by CMCD Director John Piette, the Peer-to-Peer Support Program examines the effects of peer support on depression-related health outcomes in veterans receiving mental health services at VA Medical Centers in Detroit and across Michigan. The intervention is designed to reduce barriers to patient participation in mental health care, identify individuals at risk for suicide, and complement existing VA mental health services, especially in clinics with limited resources.