City of Detroit health department transition to a private non-profit instutitue for population health

Like many major cities, Detroit has been in the midst of an economic recession. The Detroit Health Department (DHD) was not immune from the hard decisions that needed to be made. In the middle of the second term as the mayor who over saw the transition of the DHD to the Detroit Department of Health and Wellness Promotion (DHWP), he was replaced by the president of the City Council. Months later during a special election, that mayor was replaced by the current mayor. Each mayor appointed at least one director to the local health department. Since 2003 Detroit has had 5 appointed directors (and two interim directors) of the health department. Four were PhD's, three women, and four were born in Detroit. The directors were surveyed on what their goals were, the goals of the leadership that appointed them, the barriers they faced, and how they addressed them. These decisions lead up to the transition of the local health department to the private non-profit Institute for Population Health. The directors discussed maintaining programs and services beyond the public health core functions, managing current resources more effectively, and finding new revenue streams. The budget challenge was a major factor in their decision making. Hard staffing issues had to be addressed along with elimination of programs and services. Personal appearances and video of the directors will be presented. The impact of these changes on the health of the city is still being determined.