Since 2000, the Healthy Environment Partnership (HEP) has used a community-based participatory research (CBPR) approach to promote heart health and health equity in Detroit. HEP is an affiliated partnership of the Detroit URC that studies and conducts interventions to better understand and address social determinants of racial and socioeconomic health inequities, with a particular focus on cardiovascular disease (CVD).
A complex set of social determinants of health influence health inequities. HEP has examined risk factors including stressful social and economic conditions in Detroit neighborhoods, neighborhood walkability, access to healthy foods, and air pollution – all of which affect the health of Detroit residents. HEP has also examined protective factors (e.g., social relationships, participation in walking groups) and their role in reducing disease risk and negative health outcomes.
“Discrimination sets back our communities in most areas important to living healthy thriving lives,” says Angie Reyes, Executive Director of the Detroit Hispanic Development Corporation and a founding partner in HEP. “Having lead a non-profit organization in Detroit for 21 years, I have witnessed the detrimental effects it has had in our community.”
Recently, a team from HEP published research in Ethnicity and Health that demonstrates links between heightened self-reported institutional discrimination and increased blood pressure for Black and Latina/o adults. This paper builds upon accounts from residents, HEP, and multiple social movements that have documented increases in institutional and interpersonal discrimination towards communities of color.
Using data from a subset of the same Detroit residents over a six-year period in the early 2000s, the researchers measured institutional discrimination, including lifetime experiences of unfair treatment in work, education, by the police or immigration officials, housing, obtaining resources/money, or healthcare – measures that are part of the Acute Unfair Treatment Index, developed by David R. Williams and colleagues and first tested in the Detroit Area Study about 20 years ago. Blood pressure readings were collected three times during the course of interviews with participants. For this study, discrimination and blood pressure patterns were tracked over time by race and nativity.
The researchers found significant racial differences in discrimination patterns from 2002 to 2008, with non-Latino Black and Latina/o adults reporting greater increases in discrimination compared with non-Latino White adults. They also found that heightened institutional discrimination was more strongly associated with increases in blood pressure among non-Latino Black adults relative to non-Latino White adults and among Latina/o immigrants relative to US-born Latina/o adults.
“We know that discrimination makes us sick,” said Dr. Alana LeBron, lead author of the study. “These findings link increases in residents’ reports of discrimination with a sociopolitical context that has become more restrictive towards communities of color – increases in restrictive immigration policies, policing of communities of color, and an economic recession that disparately affected racial minority communities. We find that these increases in reports of institutional discrimination are linked with declines in cardiovascular health over a relatively short period of time: 6 years.”
Angie Reyes, a co-author of the paper, noted “Families worry about finances, access to equitable housing opportunities, having quality educational options for children and are being harassed by immigration officials; discriminatory practices just intensify the socioeconomic struggles our families are facing. These findings help shed light to those detrimental effects on people’s health and help change the narrative of being an individual issue to a systemic one.”
HEP Partner Organizations
- Chandler Park Conservancy
- Detroit Health Department
- Detroit Hispanic Development Corporation
- Eastside Community Network
- Friends of Parkside
- Henry Ford Health System
- Institute for Population Health
- University of Michigan School of Public Health
Community Members At-Large