Health Education & Behavior(June 2002) Schulz et al. / Social Determinants of Health
Addressing Social Determinants of
Health Through Community-Based
Participatory Research: The East Side
Village Health Worker Partnership
Amy J. Schulz, PhD
Edith A. Parker, DrPH
Barbara A. Israel, DrPH
Alex Allen, MSA
Maggie Decarlo, BA
Murlisa Lockett, MA
The authors describe the use of a stress process model by the East Side Village Health Worker Partnership
(ESVHWP), a project of the Detroit Community-Academic Urban Research Center, as a framework for under-
standing social determinants of health. Specifically, the authors describe the development by the ESVHWP
Steering Committee of a context-specific stress process model for east side Detroit residents. The authors exam-
ine data from in-depth interviews to illuminate actions taken by community members to reduce stressors or min-
imize their impact on health. Finally, the authors describe the use of this context-specific stress process model
and data gathered regarding actions to address community stressors to inform the development of interventions
by the ESVHWP to reduce stressors or strengthen the conditioning factors that reduce the impact of stress on
health. On the basis of these results, the authors discuss opportunities and challenges for partnership approaches
to addressing social determinants of health in urban communities.
Differentials in morbidity and mortality on the basis of socioeconomic status have
been firmly established by several decades of research carried out across countries,
regions, and political economies.
1-7
These socioeconomic disparities account for much of
Amy J. Schulz, Edith A. Parker, and Barbara A. Israel, School of Public Health, University of Michigan,
Ann Arbor. Alex Allen, Butzel Family Center, Detroit, Michigan. Maggie Decarlo, American Red Cross of
Greater Chicago. Murlisa Lockett, Detroit Health Department, Detroit, Michigan.
Address reprint requests to Amy J. Schulz, University of Michigan, School of Public Health, HBHE SPHII,
1420 Washington Heights, Ann Arbor, MI 48109-2029; phone: (734) 647-0221; fax: (734) 763-7379; e-mail:
ajschulz@umich.edu.
The authors wish to acknowledge the contributions of the East Side Village Health Worker Partnership. The
partnership is made up of representatives from the Butzel Family Center, Detroit Health Department, Friends of
Parkside, Henry Ford Health System, Islandview Development Coalition, Kettering Butzel Health Initiative,
University of Michigan School of Public Health, and Warren/Conner Development Coalition. It is a project of
the Detroit Community—Academic Urban Research Center and is funded by the U.S. Centers for Disease Con-
trol and Prevention, through a cooperative agreement (Grant U48/CCU515775). The authors would like to
acknowledge Sue Andersen for her contribution to the development of this article and the three anonymous
reviewers whose insightful and constructive comments on an earlier version of this article contributed to this
work.
Health Education & Behavior, Vol. 29 (3): 326-341 (June 2002)
© 2002 by SOPHE
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