April is National Minority Health Month, and that's a time to bring awareness to the health inequities that persist among racial and ethnic minorities and to take action to end those disparities.

This year's theme is be the source for better health, and my next guest is working to increase health equity in Detroit and Michigan by collaborating with community and corporate partners.

Here's my conversation with Dr. Hayley Thompson, the Director of Wayne State University Center for Health Equity and Community Knowledge in Urban Populations.

It's also known as CHECK-UP.

So I wanna start by talking about CHECK-UP and the work that you're doing here in Detroit to not only identify, but kind of coordinate responses to the health disparities that African Americans face in our community.

- Yeah.

So CHECK-UP stands for the Center for Health Equity and Community Knowledge in Urban Populations.

And we're grateful to have funding not only from the Office of Wayne State University's Vice President of Research, but CVS Health and the Office of the Chief Health Equity Officer there.

And it really is an effort to unite our academic researchers with our community stakeholders from different sectors of Detroit and the local area to come together around health equity solutions.

You know, typically, often, or at least historically, knowledge and solutions around health equity and health problems and disparities we see tend to come from academia sort of top down.

And there's been a movement over the past couple of decades to really integrate more community voice in the work that we do.

So, CHECK-UP represents that kind of effort, because we know, and I really strongly believe that good ideas and brilliance don't only lie in academia, they're not only found in academia, they're found also around Detroit communities.

Through CHECK-UP, we really see that in action.

Part of CHECK-UP includes a Detroit Community Health Equity Alliance, it's a coalition of 20 organizations, and as well as additional community residents who serve actually what we call persistent poverty areas or census tracts.

So these are census tracts in which at least 20% of the population have lived in poverty for the past 30 years.

- Wow.

- Which is different from just being a poverty track or non-poverty.

And as you can imagine, access to healthcare and health outcomes are worse in those persistent poverty tracks.

So our, we call it DCHEA, our Detroit Coalition, comes together to try to address those issues in a collaborative way.

We can't do that alone as academics, our faculty and staff and students at Wayne State alone.

We need to partner with community and not just partner with community, we need to bring that into leadership when it comes to these strategies and solutions.

- Yeah, yeah.

So let's talk about the situation we face here in the city of Detroit and the health disparities that come out of that situation, every time I see any of the numbers, they just raise the hair on the back of my neck.

They are so disparate from what we would expect in an American community.

African Americans are at risk for far more health issues than their white counterparts.

- Yeah, that's absolutely true.

We see that across the state of Michigan.

You know, the two leading causes of mortality or death in the state of Michigan are cardiovascular disease, heart disease, and cancer.

And when you look at Black/white differences, they exist across many minoritized groups.

But when you look at Black/white differences, they're quite stark.

So that mortality rates or death rates from heart disease are about 34% higher among Black Michigan residents compared to white residents.

Cancer, 32% higher among Black residents compared to white residents.

And a lot of my work and research is in cancer.

I can tell you that when you look at the city of Detroit and look at Black residents of the city of Detroit, those mortality rates are higher, even when compare them to Black people living in other parts of Michigan or Black people living in other parts of the United States.

So, you know, April is National Minority Health Month, and it's a really a good opportunity to really reflect and think about why, and what can we do about this?

- Yeah.

Let's talk about the reasons that those disparities exist.

I mean, obviously historical inequities play a huge role and current racism as well.

But there are some other things that make Detroit and Black Detroit particularly at risk for these things.

Talk about what they are.

- Yeah.

So you mentioned history and racism, and those are kind of really important starting points because that philosophy, hate practices associated with that history kind of really have a radiating effect and affect our communities.

They affect our institutions, they affect our families, and they affect our individuals.

You know, we really have gone through our major shift over the past few decades around how we look at health outcomes and the causes.

And so, you know, so often, it's very easy to say, to look at individuals and to blame individuals.

You need to go to the doctor, you need to eat better, you need to take your medication.

And those things are important.

They absolutely are.

But individuals don't exist in a vacuum.

We live in the context of families and neighborhoods.

So we've really shifted to think about multiple levels of influence on health, right.

At the community level, the institution level, policy and legislation is such a huge part of that as well.

And then when we think about that, we think also about their social determinants of health, right?

So things like transportation, public safety, the physical environment, the social environment, all these come together to influence individual health outcomes and population health as a whole.

So, you know, unfortunately, there's no one easy answer, but these are complex problems and they're gonna require complex solutions.

- Yeah.

Let's talk about National Minority Health Awareness Month.

Is the goal of something like this to raise awareness among us in the Black community or is it just as much to raise awareness outside the community for those who are charged with caring for this community, those who are charged with setting policy that affects this community to do things differently, to think about this more and to act accordingly?

- Yeah.

Thank you so much for raising that point, because certainly for people of minoritized groups, we need to have an awareness of how these different factors are affecting our health.

And we need connection to resources, right, to support a healthy lifestyle, connections to care.

But you're absolutely right.

You know, we need to think about healthcare systems and healthcare providers as playing a major part in this.

You know, we used to talk about this concept of cultural competency, right?

So it had to do with provide healthcare providers and understanding about different cultures across people of diverse groups, and being aware of the dynamics within those groups and intergroup dynamics to provide better care.

Now we talk about structural competency as well.

So how able are healthcare providers, how able are they to talk about the structural factors or the social determinants of health?

You know, are they assessing the social needs and social determinants of health among patients, right?

And do they know how to address those social needs?

In fact, you know, starting this year, CMS, the Centers for Medicaid and Medicare Services, they're now mandating that healthcare systems start to collect data on patient's social needs and connect that to the social determinants of health.

Right, so now there's greater responsibility on the part of our healthcare systems to not only track those needs, but also address them and provide people, connect people to resources.

And it'll be really interesting to see the research that comes out of this to see and understand more directly how addressing those needs really affects concrete health outcomes.

- Yeah, yeah.

And really it's about making sure that Black health is taken seriously.

I mean, we hear all these stories about the rate at which people are not just denied care, but just kind of denied even the acknowledgement that they need care because there are these disconnects, these cultural disconnects that exist between us and the medical system.

- Yeah, we certainly heard many of those stories around during the COVID-19 pandemic when people's concerns were not being taken seriously in terms of being tested for COVID.

I have to say, really the pandemic has really raised consciousness.

We kind of have now this kind of critical mass in terms of entities and people who have a much deeper understanding about not only the social determinants of health, but again, going back to the ripple effect or gradient effects of racism, implicit bias and how that affects healthcare and healthcare outcomes.

You know, a big part of that is trust and mistrust, and we really need to move the emphasis away from kind of thinking about how do we reduce mistrust among some of our patients and our populations, potentially Black patients and populations, because some of that trust is warranted.

It's absolutely valid.

There's much more a movement now in the field to think about the trustworthiness of our medical institutions and healthcare providers.

- Yeah, okay.

Dr. Hayley Thompson, it was really great to have you here with us on "American Black Journal."

Thanks so much for joining.

- Thank you.