The HIV epidemic in the Detroit Metropolitan Area

In this post, we will examine the HIV/AIDS epidemic in Michigan with particular emphasis on the Detroit Metropolitan Area. The Michigan Department of Community Health (MDCH) considers the Detroit Metropolitan Area (DMA) to include the counties of Wayne, Oakland, Macomb, St. Clair, Monroe, and Lapeer. Michigan has the 13th highest number of persons living with HIV in the United States. According to the 2012 Epidemiological Profile of HIV in Michigan, 15,753 persons were known to be infected with HIV in Michigan by the end of 2011. All told, 63% of all persons living with HIV in Michigan reside in the Detroit Metropolitan Area where 43% of the state’s population lives.

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The state separately reports data for the City of Detroit and the balance of Wayne County. As can be seen in the following graph, in 2011, HIV infection was concentrated in Wayne and Oakland counties. Over half of the persons living with HIV in the DMA resided in the City of Detroit, with 16% in the balance of Wayne County and 18% in Oakland County.

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HIV continues to disproportionally impact African Americans. In Michigan, the rate of infection is 10 times higher among black males than white males and 25 times higher among black females than white females.  Within the DMA, the infection rate among black persons is higher than for the general population. When the information is broken down by gender and race it shows there is a higher prevalence of HIV in both black males and females. According to data on the DMA, by 2011 approximately 64% of males diagnosed with HIV  and 81% of diagnosed females were black.

 

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As shown in the graph below, almost a third of persons living with HIV were between 30 and 39 years old at the time of diagnosis. The next highest number of cases occurs with persons who were diagnosed between 20-24 years or 40-49 years old, both of which were reported at 18%. This information shows the percent of those diagnosed with HIV was highest for those in the 20-29 age group, which the MDCH epidemiologist breaks down into two groups to emphasize the differences in HIV rates, especially in trend analyses. Trend data calculated by MDCH from 2006 to 2010 indicates the rate of new HIV diagnosis increased an average of 11% per year among persons 20-24 years of age and an average of 8% per year among those persons 25-29 years of age.

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HIV/AIDS is transmitted through contact with specific bodily fluids: blood, semen, vaginal secretions and breast milk (CDC, 2012).  In the U.S., HIV is most commonly transmitted through specific sexual behaviors (e.g., anal or vaginal sex) or by sharing needles or injection drug equipment with an infected person. Less common transmission routes are through oral sex, transfusions, or an HIV-infected woman passing the virus to her baby.

According to the MDCH HIV/STD/VH/TB Epidemiology Section of the Bureau of Disease Control, Prevention and Epidemiology, nearly half, 49%, of people infected engaged in “man who has sex with a man” (MSM) behavior. However, keep in mind  not all those in the MSM category are MSMs. MSM is a broad category that also includes transgenders and bisexuals; these groups would argue they are not MSMs.

Exposure through unprotected heterosexual sex constitutes 17% of HIV cases; 11% were exposed through injection drug use.

In terms of the 18% with no identified risk, this means it is too difficult to determine the exact route of exposure for such reasons as there can be at least three months or longer lag between exposure and a positive diagnosis. With such a time frame, many people are not sure of the exact cause, which is why it is listed as “no identified risk.” Also, some do not get diagnosed until they have symptoms, which could be 20 years post exposure.  Also all exposure data is, by necessity, self-reported, and some don’t acknowledge having any risks.

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More detailed information about the epidemiologic profile of HIV/AIDS in Michigan and the DMA can be found at http://www.michigan.gov/mdch/0,4612,7-132-2940_2955_2982_46000_46003-36307–,00.html

To find a free or low cost confidential HIV or STD testing location you can check the website http://hivtest.cdc.gov/Default.aspx to find free testing sites in your area. Just enter your ZIP code. Testing is confidential.

Using Data to Prioritize Demolitions

Detroit faces a huge problem with vacant housing units. The Census’ American Community Survey estimated there are 360,951 housing units in Detroit. Of these, it estimated that 253,629 are occupied, indicating that 107,322 are vacant. Given sampling error, these estimates could be off by as much as 10,000 units at a 95 percent confidence level. Even so, that means an estimate of nearly a 100,000 or 29 percent of the city’s housing units could be vacant. Many of these units are vacant and open, and not a small number have burned.

Each vacant and open unit acts like a black hole on the economic values of homes in Detroit, dragging down the values of the neighboring homes. And these become locations for illegal activities as well as environmental hazards. So, there is an urgency to demolish, preserve or repair as many as possible. However, a cash-strapped city can afford to do only so much, and Mayor Bing has said he would like to demolish 10,000.

Even so, there are many thousands of additional structures in Detroit that pose threats to city residents; the city does not currently have the funding to demolish all of these structures though. Because of this, decisions must be made about which structures to target first.  Dr. David Martin and Dr. Lyke Thompson at the Wayne State Center for Urban Studies have begun  working on a point system to identify priorities for demolition for the structures identified by the city. In order to identify the most dangerous buildings, this method considers for each address nearby crime reports, past reports of lead poisoning at that address, and the proximity to schools.

To make this work clear, we first present some overall maps of the city and then drill down on one neighborhood—the Osborn area, located in Northeast Detroit(see the map of Detroit below). Osborn, as defined for these purposes, includes many healthy areas and some areas which have experienced high rates of foreclosure and vacancy. There are many efforts underway to substantially improve the area, so it would especially valuable to identify the housing units that need to be demolished first. This is an initial effort to concentrate on housing that may produce the greatest externalities. We fully recognize that with more data this approach could be improved.

While the Osborn neighborhood is explicitly examined in this post, this map shows the frequency of lead poisoning incidences per address/home in the City of Detroit as whole. The yellow dots show there are 4,610 homes in the city with two occurrences per home; these are the most frequent. However, the blue dots, which show  three to five or six to nine occurrences per home, cover more of the map because of the higher number of people affected. There was one home in the southeast portion of the city that had 17 lead poisoning cases, according to the map.

The above map shows where all K-12 schools in the City of Detroit are located. While this post only examines the Osborn neighborhood, this map provides readers with a better understanding on the number of schools in the city and  how the point system can be used beyond the example in this post.

The above map displays the hot spots for crime, which includes property crime and violent crime, in the Osborn neighborhood of Detroit. Red means that is the “hottest” spot for crime in the area, orange/yellow comes in second, followed by green and purple. If there is no color that means it is a “cool” spot, with next to little or no crime. The area with the highest amount of crime is near Seven Mile and Gratiot. When performing hot spot mapping it should be noted that the hot spots are relative to the population size of the area being examined.

The map above shows the locations of all structures currently on the demolition list for the Osborn neighborhood. Some structures have already been slated for demolition, through an initiative from Detroit Mayor Dave Bing’s office; these are shown with yellow icons on the map.  The red icons represent 820 structures that need to be demolished according to the WSU/CUS point system but have not been funded or scheduled, according to city data. There is a high concentration of buildings near Seven Mile Road between Redmond and Schoenherr. There are also several clusters of addresses in and around the southern area of Osborn, east of Hoover Street.

As can be seen below, the number of buildings in need of demolition with no funding is greater than the number of homes slated to be demolished. So how does one establish priority? One way is a point system.

Our first effort to create a point system relies on data that the Center has available—crime data, lead poisoning data and distances to a school. Each unit on the list of unfunded structures for demolition was given a score, where:

•Ten points were given to each address within a quarter mile of a school;
•One point was given for every crime reported on the block where the structure was located;
•Two points were given for each instant that a different (as opposed to the same) child was identified as lead poisoned at an address, between 1988 to 2012.

In the map above, the each icon represents a prioritized structure with the larger the icon representing a higher score. According to this map there is a high concentration of homes near Seven Mile Road between Redmond and Schoenherr streets where units were calculated to have a high priority for demolition.  There are also several clusters of addresses in and around the southern area of the Osborn neighborhood, east of Hoover Street.

It is possible to add factors to this analysis or to adapt the weighting of particular factors. For example, vacant housing with a large amount of combustible vegetation close to housing adjacent units would create a risk of spreading fires.

In any case, unless massive funding for demolition becomes available, priorities could help cash challenged Detroit focus on the worst units first.

Crime in Detroit and Michigan

The charts below show crime rates for the City of Detroit and the State of Michigan, per 100,000 people, according for most major offenses reported to the U.S. Federal Bureau of Investigation (FBI). The rates reported for Detroit are based on reports from the Detroit Police Department, and those for the state are based on data from all reporting agencies and estimates for unreported areas in Michigan. It is important to note these are rates and thus adjust for the decline in Detroit’s population. So, any declines noted are not artifacts of decline in population. The charts address property crimes and violent crimes, with the exception of murder and non-negligent manslaughter. These will be addressed in a future Drawing Detroit post.

As will become evident, these data indicate substantial declines in crime across almost all of the categories in recent decades. This is true for both Detroit (except for aggravated assault) and Michigan.

Resources used for these charts were provided by the FBI Uniform Crime Reporting system. Detailed information can be found at http://www.ucrdatatool.gov/Search/Crime/State/RunCrimeStatebyState.cfm and http://www.ucrdatatool.gov/Search/Crime/Local/RunCrimeJurisbyJurisLarge.cfm.

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According to the FBI forcible rape is defined as “the carnal knowledge of a female forcibly and against her will.  Attempts or assaults to commit rape by force or threat of force are also included; however, statutory rape (without force) and other sex offenses are excluded.”

The above chart shows Detroit’s reported forcible rape rate was consistently higher than the state’s, with the exception of the time from 2007 through 2009. In 2007 the forcible rape rate in Michigan was recorded at 45.5 per 100,000 people while Detroit’s was recorded at 38.9. Even though the forcible rape rate for the state was higher than Detroit’s in 2007, there was a decrease in the state’s rate from 2006 to 2007 (53.0 to 45.5). Detroit also saw a decrease from 2006 to 2007 (66.9 to 38.9) in its forcible rape rate. Detroit’s rate remained in the high 30’s in 2008 and 2009 while the state’s remained in the mid-40’s. However, in 2011 Detroit’s forcible rape rate increased to 59.9 and the state’s was recorded at 44.0.

**Data were unavailable for 1993 in Detroit because “data collection methodology for the offense of forcible rape used by the State Uniform Crime Reporting (UCR) Program did not comply with national UCR Program guidelines.”

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According to the FBI robbery is defined as “the taking or attempting to take anything of value from the care, custody, or control of a person or persons by force or threat of force or violence and/or by putting the victim in fear.”

During the time period from 1985 through 2011, the reported robbery rate in Detroit had been higher than the state’s. In 1985 Detroit’s robbery rate was reported at 1,537.6 per 100,000 people while the state’s was reported at 292.4; this was the largest recorded difference from 1985 through 2011. The state’s robbery rate remained fairly steady since 1985, with a small decrease over time. Until 2005 Detroit saw a steady decline, but the rate has bounced up and down the last several years. In 2011 the robbery rate for the state was reported to be 105.2 and Detroit’s was reported at 695.7.

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According to the FBI, aggravated assault is defined as “an unlawful attack by one person upon another for the purpose of inflicting severe or aggravated bodily injury.”

The reported aggravated assault rate in Detroit increased from 1985 to 2011, despite large decreases over certain periods of time (2000-2004 and 2005-2008). In 1985 Detroit’s rate was reported at 635.0 per 100,000 people, and in 2011 it was reported at 1,333.6. Whereas, the recorded aggravated assault rape for Michigan from 1985 through 2011 was never above 472.1 (reported in 1993). In 2011 the aggravated assault rate for the state was reported at 289.9.  Since 1993 there has been some variability, but overall a slightly decreasing trend for the state.

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According to the FBI, property crime “includes the offenses of burglary, larceny-theft, motor vehicle theft, and arson.  The object of the theft-type offenses is the taking of money or property, but there is no force or threat of force against the victims.”

There was a decrease in the reported property crime rate for both Detroit and Michigan from 1985 to 2011. However, the state of Michigan’s rate had a more stable decrease than the City of Detroit’s rate. The state’s property crime rate decreased from 5,632.2 per 100,000 people in 1985 to 2,621.1 in 2011. From 1992 to 1996 the property crime rate in Detroit increased from 8,696.2 to 9,672.7,but starting in around 1997 a decline began, and by 2011 the rate was reported at 6,143.5.

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According to the FBI burglary is defined as, “the unlawful entry of a structure to commit a felony or theft.  To classify an offense as a burglary, the use of force to gain entry need not have occurred.”

The reported burglary rate in Detroit had a decreasing trend from 1985 to 2004, but this rate began increasing as the economy in Southeastern Michigan began a steep decline. Only in the last year has this shown evidence of reversing, coincident with the improvement in the economy. The highest reported burglary rate from 1985 through 2011 for Detroit was in 1985; it was reported to be 3,703.1 per 100,000 people. In 2004 the burglary rate had declined to 1,334.5, which was the lowest rate for Detroit during this time series. With some ups and downs, the rate ended up at 2,242.4 in 2011. The highest burglary rate for the state was also in 1985 when it was reported at 1,527.2, and the state’s rate decreased overall since then with a recorded rate of 724.9 in 2011.

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According to the FBI, larceny theft is defined as “the unlawful taking, carrying, leading, or riding away of property from the possession or constructive possession of another.”

While the recorded larceny theft rate in the City of Detroit remained higher than the rate in the State of Michigan from 1985 through 2011, the difference between the larceny rate in Detroit and in the state was the smallest difference of all the crime rates addressed in this post. The difference between larceny theft rates was the smallest in 2005 when Detroit’s rate was 1,929.9 per 100,000 people and the state’s was 1,922.0.  In 2011 the rate for Detroit was 2,307.2 and the state’s was 1,629.0.

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According to the FBI, motor vehicle theft is defined as “the theft or attempted theft of a motor vehicle.”

From 1985 through 2011, the reported rate of motor vehicle theft in Michigan showed a gradual decreasing trend over time. Detroit’s rate had many peaks and valleys. There was a large, continuous decrease in Detroit’s rate from 2006 to 2009; it decreased from 2,593.8 per 100,000 people to 1,432.2. After rising and falling over the last few years, it was at 1,593.9 in 2011. Both the Michigan and the Detroit long term declines are partly due to substantial improvements in the security systems built into cars, which are making it far more difficult to steal cars built in recent years.

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The above chart shows the rate (per 100,000 people) of criminal offenses reported in 2011 for the seven crimes addressed in this post for the City of Detroit and the next four largest cities that are part of the Metropolitan Statistical Area that includes Detroit. Detroit had the highest rate of offenses reported of the five communities for all of the crimes, with the exception of larceny. Dearborn has the highest larceny rate.