CAIRO – Described as a rising star in the study of how social factors affect public health, a Detroit Muslim doctor has decided to come home, offering health care to the poorest big city in America.

“I think I want to be the health commissioner for Detroit,” Dr. Abdul El-Sayed told a mentor in New York, STAT News reported.

The decision to come home came last summer when the 31-year-old university professor and former Rhodes scholar was in New York.

Having already earned a doctorate in public health at Oxford and a medical degree at Columbia, he was tired of simply studying public health problems and wanted to help solve them

Choosing Detroit, the poorest major city in America, the task was not easy for the young doctor, who is born to Egyptian Muslim immigrants.

The biggest issues for Detroit’s health department are tied to poverty as 4 out of 10 residents live below the poverty line, suffering decades of neglect.

Infant mortality is higher here than in any other major American city, and higher than in some foreign countries, including Mexico.

Nearly 4 out of 10 Detroit adults are obese. The rate of asthma hospitalizations in the city is more than three times higher than the state average.

“The hard thing about a turnaround is, there’s no launch date, right? You already launched a long time ago,” El-Sayed told STAT during an interview in his Detroit office.

“You have to keep and improve, even, the quality of city services even as you are fundamentally [shifting] the gears inside the machine.”

The move was appreciated by many Detroit residents and officials.

Ricardo Guzman, chief executive officer of Detroit’s Community Health and Social Services Center, recalls turning on the television one night and seeing El-Sayed meeting with a group of residents to discuss the city’s animal control operations.

“I was sitting in my chair saying, ‘Damn. He’s out there.’ That’s a good thing. We haven’t seen that in years,” Guzman said.

“I think we’re at that crossroads where people are starting to feel good about what’s happening,” both under the mayor and under El-Sayed, said Guzman.

“He is setting the tone for the department, and it’s a very positive one.”

Helping Others

El-Sayed’s decision to choose public health field followed a disturbing incident at New York-Presbyterian Hospital.

A woman who had been drinking and hit her head had come into the hospital, who had AIDS and was likely an alcoholic.

As he tried to convince her to go to rehab for two weeks, then back to specialized housing to take care of her medical needs, she insisted on going home with her daughter.

Two weeks later, he got on the subway to go to dinner with a friend and there was the woman, sleeping on the subway.

“I went home that night and pulled my residency application,” El-Sayed recalled. “Medicine is not the way to solve these kinds of problems.”

“This was a woman with an eighth-grade education who the system failed far, far before she was a patient at that hospital that day.”

The field appealed to El-Sayed’s interest in figuring out why public health problems are so much worse among some populations than others, especially among minority groups.

“I think Abdul has always been driven to improve the health of the population and narrow the health gaps,” said Sandro Galea, a mentor of El-Sayed’s and dean of the Boston University School of Public Health.

“He’s an exceptional person. He’s smart, he’s thoughtful, and he’s well-intentioned — and that’s fairly rare, frankly.”

At this moment, he pulled his residency application, contacting a friend who was working for the mayor of Detroit.

After a two-hour lunch meeting, the mayor told El-Sayed the job was his if he wanted it.

Amid frustrating environment, the young doctor is trying to build a “sense of partnership” between his department and other city agencies, but is already finding it hard to get rid of the bureaucratic inertia.

“Are there people suffering? Yes. OK, then clearly the way that we’re doing it right now is not working,” he said. “So if we can forget ourselves for a minute, sit down together and say, ‘Who has what ingredient to try and bake a better loaf?’”

“Let’s do that together.”