WELCOME TO THE DETROIT NEIGHBORHOOD HEALTH STUDY

About Our Study

The Detroit Neighborhood Health Study (DNHS), a 5-year study funded by the National Institutes of Health, was conducted by the Center for Social Epidemiology and Population Health at the University of Michigan School of Public Health. The study is permanently closed to the enrollment of new subjects. All interventions and follow-up are complete.

A. SPECIFIC AIMS

Increasingly, evidence is emerging to suggest that stressors at multiple levels are important predictors of psychopathology and behavior. Post-traumatic stress disorder (PTSD) and drug abuse/dependence are among the most prevalent and disabling behavioral pathologies. The purpose of this project is to determine whether ecologic stressors (concentrated disadvantage, income distribution, residential segregation, quality of the built environment) influence the risk of PTSD and drug abuse/dependence among residents of Detroit. Additionally, we will begin to explore the pathways linking ecologic stressors and long-term health through assessing the interrelationships among ecologic stressors, exposure to potentially traumatic events (PTEs), PTSD, and drug abuse/dependence, and the relationship between PTSD and immune function. Our central hypothesis is that exposure to ecologic factors is a fundamental determinant of population mental health and that, particularly in the urban context, ecologic factors influence (a) the risk of PTE exposure, (b) the risk of PTSD given exposure to a PTE, (c) the risk of drug abuse/dependence, (d) the interrelationship between PTSD and drug abuse/dependence, and (e) some of the consequences of psychopathology. Although recent work has shown that stressors at multiple levels may be important determinants of psychopathology, there has been very little systematic effort to understand the contributions of ecologic stressors to the risk of incident PTSD or drug abuse/dependence while concurrently accounting for individual stressors. Secondarily, we propose to consider the consequences of PTSD, particularly the relation between PTSD and immune function, and how immune and inflammatory responses are shaped by exposure to ecologic and individual stressors. Our overall goal is to assess the relationship between exposure to ecologic stressors, PTSD, and specific immune and inflammatory responses in order to elucidate the potential biological pathways underlying the relationship between psychosocial stress, PTSD, and consequent physical morbidity. The specific aims of this proposal are:

AIM 1. To determine the longitudinal associations between specific ecologic stressors (concentrated disadvantage, income distribution, residential segregation, quality of the built environment), exposure to PTEs, and PTSD among residents of Detroit, independent of key individual-level factors (e.g., gender, race/ethnicity, discrimination). Hypotheses: Persons who are exposed to the ecologic stressors of interest will have (a) greater likelihood of PTE exposure, (b) greater likelihood of PTSD, (c) and higher conditional probability of PTSD given PTE exposure, and (d) longer duration of PTSD symptoms when controlling for individual-level factors.

AIM 2. To evaluate the interrelations among ecologic stressors, PTSD, and differentials in inflammatory response [assessed through C-reaction protein (CRP)] and immune functioning [response to Epstein-Barr virus (EBV), Herpes simplex virus type 1 and 2 (HSV-1 & HSV-2), and cytomegalovirus (CMV)], and to examine these relationships among individuals who use drugs and those who do not use drugs. Hypotheses: (a) Persons exposed to ecologic stressors have higher measures of inflammatory function and measures of cellular immune response than persons not exposed to ecologic stressors; (b) persons exposed to ecologic stressors and who have PTSD symptoms have the highest inflammatory function and immune response; (c) drug use will modify levels of circulating inflammatory and immune response markers.

We will use data from multiple sources to achieve these aims. First, we will recruit 1500 residents of Detroit geocoding each respondent to their area of residence. All respondents will be randomly recruited using a dual-frame probability sample design from Detroit’s 54 neighborhoods, recruiting a representative sample of the Detroit population. Persons recruited in the cohort will be interviewed at baseline and followed in two subsequent survey waves during the study period to allow for the assessment of incident cases. The cohort participants will provide information on PTSD, drug abuse/dependence, and individual stressors that are of interest at each assessment time-point, and information on key covariates. Second, we will use systematic ecologic assessment (conducted three times, coincident with each survey wave) and data from archival sources to assess ecologic stressors. Third, we will obtain blood samples to measure a key inflammatory marker (CRP) and measures of cellular immune response (to latent EBV, HSV, and CMV). Multilevel modeling will be used to evaluate whether ecologic stressors are associated with PTSD and drug abuse/dependence and to assess the relation among ecologic stressors, PTSD, immune functioning, and inflammatory measures. Through bringing together a team with expertise in urban health, survey research, epidemiology and psychoneuroimmunology, this proposal builds on existing momentum and stands to make a substantial contribution to our understanding of the etiology of PTSD, drug abuse/dependence, and their consequences.

ANNOUNCEMENTS

Phase 5 Concluded

Phase 5 survey collection began in September 2013 and the specimen collection began in October 2013. Collection concluded in spring 2014. Thank you to all of the Detroit residents who participated as well as the research team for making year 5 and DNHS as a whole a success!

Phase 4 Concluded

Phase 4 survey collection began in September 2011 and the specimen collection began in October 2011. Collection concluded in March of 2012. Thank you to all of the Detroit residents who participated as well as the research team for making year 4 a success!

Symposium-Flyer

2011 Symposium: “Health in the City”

The 2011 DNHS Symposium took place on Thursday, April 21 from 9:00am until 12:00pm at the UM Detroit Center at Orchestra Place. This year we were pleased to have speakers from Henry Ford Health System, Wayne State University, and University of Michigan School of Public Health join us for presentations and discussion on the health of Detroit residents. Selected presentations from the symposium are available below.

We’re Making News!

We are pleased to announce that we, along with our research partners at Wayne State University, Harvard University, Columbia University and University of Tubingen in Germany, are making news with a paper that was just published in the online edition of the Proceedings of the National Academy of Sciences. Dr. Sandro Galea was interviewed recently on National Public Radio about the paper, Epigenetic and immune function profiles associated with posttraumatic stress disorder. Lead author Dr. Monica Uddin participated in several interviews including a podcast for the University of Michigan News Service.

Phase 3

Phase 3 survey collection began on September 21, 2010 and the specimen collection began on October 20, 2010. Both collections will continue through spring 2011. If you are a participant and have questions about the survey, please call AbtSRBI toll-free at 888-812-9285. For questions about the specimen collection please call 734-647-8438. If you have not received your check by 6 weeks from the day your specimens were collected, please call 1-646-486-8411.

2009 Symposium: “Health in the City”

Click on the links below to view the four slide presentations from our first annual DNHS mini-Symposium, “Health in the City,” held on Thursday, December 3, 2009.

  • Health in the city: Findings from DNHS (PDF)
  • Assessing Ecological Stress, Resiliency and Self-rated Health in Detroiters (PDF)
  • Community Action Against Asthma (PDF)
  • Health in the City Symposium (PDF)