How researchers can help win the long game on public health

September 18, 2019

A partnership between Delray residents, community leaders, University of Michigan researchers and students could be a template for advancing campaigns for environmental justice.

Assistant Professor OF Public Health Natalie Sampson (center) walks with senior Valeria Cossyleon (right) and Janine Hussein (‘18), two UM-Dearborn students who helped collect door-to-door health surveys.
In Detroit’s Delray neighborhood, Assistant Professor OF Public Health Natalie Sampson (center) walks with senior Valeria Cossyleon (right) and Janine Hussein (‘18), two UM-Dearborn students who helped collect door-to-door health surveys.

UM-Dearborn Assistant Professor Natalie Sampson’s research into public health issues in Detroit’s Delray neighborhood has spanned a decade — and even has begun to play a role in shaping public policy. But when talking about the years of work, she definitely prefers shining the spotlight on the community and her partners. Among the collaborators she’s quick to acknowledge are Southwest Detroit’s determined organizers and her public health colleagues at UM-Ann Arbor. She also speaks with particular affection about her students, who’ve done the intense, intimate door-to-door work of collecting health testimonies from individuals who shoulder an outsized share of environmental burdens. 

For decades, life in Delray has been set against a heavily industrialized landscape that features, among other things, Zug Island’s steel and coke operations, an oil refinery, Detroit’s major sewage treatment plant and the I-75 freeway. Not surprisingly, residents disproportionately report dealing with a number of health issues, especially respiratory problems, which Sampson and her partners’ work has helped shine a light on in recent years. Even so, industrial development in Delray appears to still be in a growth phase. Most notably, the neighborhood was chosen a few years ago as the site of the new Gordie Howe International Bridge — a massive infrastructure project that could double truck traffic between the U.S. and Canada when it opens in 2024.

When news of the proposed bridge broke, Sampson says residents in Delray expressed their concerns — most notably over how construction and bridge traffic would affect the neighborhood’s already poor air quality. But the prevailing thought among community leaders wasn’t to mount an uphill campaign to stop the project. Instead they focused on what could be done to minimize further environmental impacts and create economic opportunities for the neighborhood. The Southwest Detroit Community Benefits Coalition formed around that purpose, and organizers started discussing what they might campaign for and how they could make their case.

Sampson remembers going to some early community meetings focused on the bridge, where she presented preliminary findings of a neighborhood health survey to representatives from then-Governor Snyder’s office. “At the time, I didn’t really see it as groundbreaking — partly because what we documented seemed pretty obvious to the residents,” Sampson remembers. “We knew there were disproportionate levels of respiratory problems and pollution-related issues in the neighborhood. But the data helped decision makers understand the very real health implications of this project.”

Over the past several years, the coalition held dozens of such meetings amongst themselves and with decision makers, often integrating Sampson and her partners’ health research. And their work has added up to some meaningful wins for the neighborhood. Most notably, in 2017, the city and state announced a $45-million community benefits package that included an unprecedented relocation program — providing some Delray residents the option of moving to a renovated Detroit Land Bank home. But there were also other benefits in the agreement, including a three-phase Health Impact Assessment (HIA), which would both collect baseline data about residents' health prior to construction of the bridge and track environmental and health impacts during construction and operation. It would also offer practical recommendations for how to minimize adverse health effects. 

A team led by Sampson, several researchers at UM-Ann Arbor, the Detroit Hispanic Development Corporation and the Southwest Detroit Community Benefits Coalition won the bid to conduct the HIA, which is expected to be released this fall. As with her earlier surveys, Sampson notes many of the health issues they documented won’t qualify as surprises to residents. For example, the HIA reports that among children under the age of 18, who live within 500 feet of I-75 or trucking routes through the Gordie Howe International Bridge area, asthma prevalence was 16.3 percent. That compares to 11.6 percent for those living more than 500 feet away and 8.4 percent in the U.S. This and other findings, Sampson says, demonstrate that there are strategies to protect residents' health — including expanding the optional home swap program to include all residents living within 500 feet of the new bridge, or assuring that entrance and exit ramps avoid residential neighborhoods.

Sampson says this kind of long-game, one-victory-at-a-time approach is typical of campaigns for public health, which often demand tireless frontlines work by residents. “With public health, there usually isn’t a single leverage point. It’s something that has to be constantly injected into the conversation for people to value its importance,” Sampson says. “In almost all cases for projects like this, health impact assessments are elective; they’re not required by law, like environmental impact assessments. So it’s an important victory for the community and an important recognition by the city. The fact that there is a focus on health shows our collective understanding of these issues is beginning to evolve.”