Detroit Needs Assessment Study: A Community Academic Partnership With the Detroit Area Agency on Aging

This presentation discusses a comprehensive needs assessment to inform long-term strategic planning for the Detroit Area Agency on Aging. The goal was to provide in-depth input from the older population (age 60+) and key agency stakeholders, using surveys (413 community participants), listening sessions (132 participants), 23 interviews with homebound older adults, and online surveys (94) targeting medical, church, government, academic, media and HSO stakeholders. Findings indicate that many participants were not aware of available community services. For example, one-third (33.3%) had not heard of Medicaid waivers providing services outside of nursing homes, while nearly one in five (22.0%) had not heard about senior employment services. The most common areas of unmet need were for caregiver workshops (16.3%) and diabetes management classes (15.7%). Community services most often noted as ‘extremely important’ included health and wellness programs (68.8%), services to help access health and supportive services (71%), easy to find service information (67.7%), home care and housekeeping services (66.4%), and caregiver support (63.7%). Stakeholder findings provide insight regarding this lack of awareness. Asked “How familiar do you think the general public is with DAAA?” , 10.8% answered ‘very familiar’ and 33% ‘unfamiliar’. Findings related to an “Age-Friendly City” suggest the importance of access to supportive community services, transportation, safety, housing, and healthcare. Engagement of older adults in needs assessments plays a vital role in Area Agencies on Aging meeting the needs of emerging aging cohorts by developing ‘age friendly’ strategies to address increasing racial, ethnic, socioeconomic, and cultural diversity.

Pregnant Black Women and Emergency Department Utilization: Assessing Self-Reported Receipt of Prenatal Counseling

There is limited literature on emergency department (ED) use among pregnant women. In this article, we examined the associations between prenatal counseling with the use of the ED during pregnancy. In our cohort of Black women in the Metro Detroit area, we found that approximately 70.5% of the women had an ED visit at some point during pregnancy. In unadjusted models of prevalence ratios, we found women reporting receipt of prenatal counseling regarding fetal movement, what to do about baby’s movement slowing down, and smoking (but not what to do about smoking) were at statistically significantly greater risk of ED utilization during pregnancy. Adjustment for confounders slightly weakened the associations for counseling about baby’s movement or smoking, so that the associations were no longer statistically significant. These findings call for further research on ED utilization among this population, especially differentiating urgent versus non-urgent use of the ED during pregnancy.

The Impact of COVID-19 Response on Central Line Associated Bloodstream Infections and Blood Culture Contamination Rates at a Tertiary Care Center in Greater Detroit Area

A comparative retrospective study to quantify the impact of Coronavirus Disease 2019 (COVID-19) on patient safety. We found a statistically significant increase in central line-associated blood stream infections and blood culture contamination rates during the pandemic. Increased length of stay and mortality was also observed during COVID-19.

Anticipating Images

This chapter begins with a newspaper ad placed at the beginning of the previous century that depicted the newly constructed George N. Pierce manufacturing plant at Buffalo. It describes the plant as a new kind of industrial architecture that satisfied the demands of rapid technological change in the United States over the last decades of the nineteenth century and the first decades of the twentieth century. It also talks about the growth of US industry in the early twentieth century that coupled market capitalism with scientific optimization moderated by Progressive Era reforms. The chapter reviews the industry that came into being in the United States in the wake of a “Second Industrial Revolution,” which was produced by the architecture firm of Albert Kahn Associates. It considers the historical resource that photographs constitute from the archives of the US industrial architecture under construction between 1905 and 1945 in the Detroit area collections.