With the city on the verge of bankruptcy, most of the department's remaining services were contracted out to a private agency, the Institute for Population Health (IPH).
They focused on mostly environmental issues, which included cleaning up the Detroit (and surrounding) rivers and controlling and providing public water supply and sewage disposal systems.
[1] During this smallpox epidemic the city's first public hospital was built in 1839 to care for homeless and impoverished Detroit residents.
Between 1848 and 1881 another small public hospital was built and the Board of Health rented houses where they could employ nurses, officers, agents, etc.
This hospital was operated by the Sisters of Charity to care for ill patients with contagious diseases until 1892, when it was destroyed by a fire.
In 1894 a small frame building was erected to handle the continuing smallpox epidemic, while other infectious diseases were treated in private hospitals.
[1] Due to the increasing outbreaks of contagious diseases within the City of Detroit in the beginning of the 1900s, a more permanent and suitable facility began to be constructed.
In 1928, the construction of the main building of the Herman Kiefer Hospital (which currently sits along Taylor and the M-10 freeway) was completed.
Due to the high levels of typhoid fever, smallpox, and diphtheria, Dr. Vaughan required physicians to practice preventative medicine by administering vaccinations and attending conferences to become up to date on current treatments for these diseases and future health issues.
[9] Due to advances in technology and treatment, especially vaccines, the number of contagious diseases in the US, and in the city of Detroit, began to decrease.
[5][10] By the mid 1960s two of Herman Kiefer's 7 pavilions had been closed and demolished to construct Clare M. Sanders Elementary School and the hospital portion of the campus had scaled back on its tuberculosis clinic operations.
[5] Between 1980 and 2010 the Detroit Health Department went from providing over 40 services and programs to the public to around 30, and the number of clinics that it had throughout the city reduced from 10 in 1980, to 5 in 1988, and down to 2 (outside of Herman Kiefer) in 2007.
[19] On December 13, 2013 Birth and Death Records, one of the largest and oldest operations within the Detroit Health Department, was permanently closed and this service was transferred over to the Wayne County Clerk's Office.
Mayor Mike Duggan[21] had been elected, and with a "fresh start", the focus of the city government was to provide the services that the people of Detroit needed.
Wayne State University School of Medicine took over infectious disease testing and treatment, and organizations such as the Arab American and Chaldean Council (ACC), Moms and Babes, and Community Health and Social Services (CHASS) took over WIC programs.