This article is part of State of Health, a series examining health disparities, how they affect Michigan's children and seniors, and the innovative solutions being developed to address them. It is made possible with funding from the Michigan Health Endowment Fund.
In December 2008, Classic Chevrolet shuttered its location in Wyoming, just outside Grand Rapids. The huge building stood empty. But in 2012, Cherry Health transformed the dealership's showroom and offices into spaces for medical, behavioral health, and dental clinics, later adding a vision clinic in the former service bays.
"We were looking for a site that could serve the city of Wyoming and southwestern Grand Rapids as a federally qualified health center," says Mike Reagan, Cherry Health external relations officer. "The former Classic Chevy was centrally located, easy to access by public transit, and … gave us the potential to grow."
The neighborhood surrounding Cherry Health's Wyoming location includes many low-rent apartment complexes as well as modest single-family homes — an area where many displaced by housing costs in Grand Rapids' gentrified neighborhoods are now seeking housing. In addition, much of Wyoming's homeless population lives in tent encampments a mile or two away. The location is also convenient for people living in income-challenged neighborhoods of southwest Grand Rapids.
"The whole purpose is that we can serve anyone regardless of their ability to pay," Reagan says.
Cherry Health has repurposed multiple buildings for healthcare throughout its 30-year history, and it isn't alone in doing so. The mission of expanding health equity has inspired many Michigan providers to transform defunct, nontraditional spaces into healthcare facilities.
The benefits are twofold. Marginalized Michigan residents are finding health services in locations they can access in their neighborhoods or via public transportation. And buildings that had sat vacant, as potential sources of blight, have become the bright spots on the block.
From a small room in a mosque to a renovated church
When it opened in 2004 within the Muslim Center of Detroit, the Health Unit on Davison Avenue (HUDA) was a monthly, one-room clinic staffed by volunteer doctors. In its new site within a former Jehovah's Witnesses Kingdom Hall in central Detroit, HUDA now serves more than 300 patients a month, four days a week, providing adults primary care, ophthalmology, dental, podiatry, and mental health services. The free clinic also offers ultrasound, dietitian services, Medicaid enrollment, and hosts special events like "Project Happy Feet" for people experiencing homelessness.
"We serve the uninsured and the underinsured," says HUDA executive director Eman Altairi. "Our current location has helped us tremendously. It's large enough to see many patients and have an administrative side and health education, right across the street from the Muslim Center."
HUDA executive director Eman Altairi
Senior clients especially benefit from HUDA's main food garden, which grows fresh produce to address four specific health conditions: diabetes, hypertension, inflammation, and anemia. Four additional raised beds are open to the neighborhood.
"Any time of the day, they can pick that produce. Everything is for free," Altairi says. "This area has only liquor stores and corner stores. The garden provides our patients and neighbors with access to healthier food options."
While the clinic does not see children as patients, its outreach program sends doctors, an EMT unit, and local medical students to local schools for "Be a doctor for a day" events.
"We are trying to shift to more mentorship, more services to youth," Altairi says.
Schools retooled to boost health equity
When Macomb County Health Department assessments revealed that the department's programs weren't reaching the county's growing African American, Latinx, and Chaldean populations, two former school buildings were repurposed as community centers that co-locate healthcare services with multiple social service agencies.
"We're just scratching the surface of the potential," says Rhonda Powell, director of the Macomb County Department of Health and Community Services. "As more partners come to the table, we're really putting together a holistic service that comprises everything that goes away when a school closes: youth sports, recreation, adult learning, onsite vision and hearing testing, the school nurse and social worker.
"We've tried to make sure all those services are still accessible within the centers."
In Mount Clemens, the Macomb County Family Resource Center houses the Central Community Action Center, Community Development, the Macomb Food Program/Client Choice Pantry, and a Head Start child care program for children up to age five. In partnership with the Macomb County Health Department, children enrolled in the Head Start program receive health and vision screenings as well as dietary assessments and targeted services for low-birth-weight infants.
Mothers and infants coming in through the WIC program who are in foster care, receiving food or medical assistance, or experiencing homelessness are automatically enrolled in the center's Head Start program.
Macomb County Family Resource Center
The Max Thompson Family Resource Center in Warren offers pregnant women wellness screenings in between regular prenatal visits as well as WIC services. Its Nurse-Family Partnership program provides in-home consultations to first-time moms. The Center also provides well child check-ups, supplemental food program registration, and transportation to medical appointments. South Community Action Center, a partner agency, provides utility and rent assistance in the same location.
When the schools on both sites closed, the surrounding community felt their loss – and it wasn't easy to sell the buildings, especially with the Mount Clemens building still under a bond. But by repurposing buildings that already felt familiar and comfortable to people living nearby, the community centers have been successful in drawing neighbors to a wide range of services, including healthcare. Both centers continue to seek additional tenants that share the same vision for serving the community.
"The partnership was a win-win for us and the school districts," Powell says.
From a room in a community center to the heart of a neighborhood
Started within the Hispanic Center of West Michigan, Mercy Health Clinica Santa Maria soon moved to its own building in a Grand Rapids Latinx neighborhood. Today, its staff and nine providers — all bilingual — serve 250 patients a day. The clinic's remodel and expansion is part of the Plaza Roosevelt development, which includes a new public high school, 17 Habitat for Humanity homes, 48 affordable apartments, and commercial development.
In addition to adding six consultation rooms, the clinic will offer a drive-through pharmacy, per its patients’ feedback.
"We've reached that point again. We have run out of space," says Jo Ann Gorby, practice leader at the clinic. "As part of the Plaza Roosevelt project, we're working with neighbors and taking their cues."
Like other clinics in income-challenged neighborhoods, Clinica Santa Maria melds many adjunct services into its healthcare practice. Behavioral health services, a WIC program, financial and food assistance, English classes, and family events have made the clinic a safe neighborhood gathering place where immigrants need not fear, no matter their immigration status.
For the 250 expectant mothers seen every year, pampering events provide a relaxing night out, vital pregnancy information, and a diaper bag, complete with layette. The "Reach Out and Read" program gives every child between six months and five years of age bilingual books their parents can read to them. A back-to-school event provides more than 260 children with backpacks full of school supplies each year.
By utilizing their sites to provide adjunct services, all of these healthcare locations can address both medical issues and the social determinants of health, transforming both lives and neighborhoods.
"We recognize that our patients' last concern is healthcare. They need things like food on the table, housing, and clothing," Gorby says. "We have found that the more we do within our walls, the more successful we are with our patients."
Estelle Slootmaker is the development news editor for Rapid Growth Media, communications manager for Our Kitchen Table, and chairs The Tree Amigos, City of Wyoming Tree Commission.
Cherry Health photo courtesy of Cherry Health. Macomb County Family Resource Center photo courtesy of Macomb County. All other photos by Nick Hagen.