Drug Death Rates Increase Across Southeastern Michigan

Macomb County had the highest rate of drug related deaths in 2014 coming in at 30.9 per 100,000 people, according to the Michigan Department of Health and Human Services. Wayne County’s overall rate was 27.4 per 100,000 people. If one looks at Wayne County, excluding the City of Detroit, then out-Wayne had the highest rate of drug related deaths in Southeastern Michigan at 31.3. Detroit’s rate was 21, about equal with Oakland County at 20.8. Regionally, Washtenaw County had the lowest rate of drug deaths in 2014 at 18.5 per 100,000 people.

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Livingston County experienced the highest percent change in drug related deaths at 253 percent. In 2005 Livingston County’s rate was 7.8 and by 2014 that number increased to 27.5. Although Washtenaw County had the lowest rate of drug related deaths in 2014, like the other counties in the region, it experienced an increase in drug deaths since 2005. The increase in drug related deaths, regionally and across the state, is partially because of the increased use in opioids and heroin. Just this month the Detroit Free Press reported 19 people in Wayne County died from an elephant tranquillizer-carfentanil-that was mixed with the heroin or other street drugs.

 

While drug related deaths for the counties increased regionally, the City of Detroit experienced a 19 percent decrease. In 2014 the City’s drug related death per 100,000 people rate was 21, which was higher than both Oakland and Macomb counties. In 2005 the rate for the City was 26.

 

According to the Michigan Department of Health and Human Services the increase in drug poisoning deaths began in 2012. For heroin alone, the rate of related deaths increased from 2.3 per 100,000 people in 2012 to 4.5 in 2014. Statewide, it was individuals between the ages of 25-34 who had the highest death rate involving heroin. According to the Michigan Department of Health and Human services in 2014 11.4 per 100,000 individuals died from a drug poisoning involving heroin and 12 per 100,000 individuals in the 35-44 age bracket died from a drug poisoning involving opioids-which include heroin and pain killers.

Hospital Bed Access Highest in Ann Arbor

Access to healthcare is necessary for disease prevention, a longer life expectancy and an overall increased quality of life. Both regionally, and nationally, those living in rural areas have far less accessibility to hospitals. Under the Medicare Rural Hospital Flexibility Program created by Congress in 1997 Critical Access Hospitals were created to strengthen health care access in rural areas. There are 36 Critical Access Hospitals in the state of Michigan, none of which are located in Southeastern Michigan. Critical Access Hospitals must be located in a rural area and be more than 35 miles from another hospital. Hospital bed access throughout Southeastern Michigan is concentrated in more heavily populated areas, leaving dozens of rural communities with limited access. The city of Ann Arbor has the highest overall hospital bed per capita (per 1,000 people) access, largely due to the University of Michigan Health System being located there.

All data for this post was provided by the Michigan Department of Health and Human Services. According to the department, the number of registered hospital beds can remain registered to a hospital even if it is closed. This is particularly true if the beds from the closed hospital are being transferred to a new hospital. This is the case for DMC Surgery Hospital in Oakland County; this hospital is closed but 25 of its beds are being transferred to the Children’s Hospital of Michigan (also located in Oakland County). The remaining 11 beds will be delicensed.

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In total, the University of Michigan Health System had 1,000 licensed beds in 2016, according to the Michigan Department of Health and Human Services. Regionally, this hospital has the second highest hospital bed count next to Beaumont Health Systems’ Royal Oak location, which has 1,040 licensed beds. Aside from the University of Michigan Health System located in Ann Arbor, there is also St. Joseph Mercy in Ann Arbor with 513 registered beds. Outside of Ann Arbor in Washtenaw County there were two other hospital facilities.

 

Despite Washtenaw County having the highest hospital bed access per capita in the region, Wayne County had the highest number of hospitals, 12 of which were located in the city of Detroit. In Wayne County, Henry Ford Hospital in Detroit had the most number of licensed beds at 877.

While hospital bed access is prevalent in the more densely populated areas, such as Ann Arbor, Detroit, and the tri-county metro region, it lacks in the rural areas. For example, in Monroe County there is only one hospital-Promedica Monroe Regional Hospital-with 217 registered beds. Per capita hospital bed access in Monroe County is 1.5 per 1,000 people, which is actually higher than Macomb County’s Per capita hospital bed rate (1.4 per 1,000 people). This difference though is not because of the total number of licensed beds in each county (there are 1236 in Macomb County) but the differing population numbers.

In Livingston County there was only one hospital-St. Joseph Mercy Livingston Hospital-with 136 licensed beds. This put the hospital bed access rate per 1,000 people for the county at .7, the lowest in the region, furthering highlighting the lack of hospital bed access in rural areas. Much of northern Macomb County and St. Clair County also had such lack of access.

Detroit has Highest Percentage of Kids Tested for Lead Poisoning

In 2015 about 37 percent of children under the age of 6 in the city of Detroit were tested for an elevated blood lead level, according to data provided by the Michigan Department of Health and Human Services. This was the highest percentage of children tested in the state; Livingston County had the lowest percentage of children under the age of 6 tested at 8.91 percent.

As shown in an earlier post, we also saw that in 2015 Detroit had the highest percentage of children under the age of 6 with blood lead levels elevated above 5 ug/dL at 7.5 percent, according to the Michigan Department of Health and Human Services. Similarly, Livingston County had among the lowest percentage of its child population under the age of 6 tested for elevated blood lead levels while also having less than 2 percent of its child population test positive for elevated blood lead levels.

According to the Michigan Department of Health and Human Services, all children enrolled in Medicaid are considered to be at risk for lead poisoning. Michigan Medicaid Policy requires all children between the ages of 12 and 24 months ages be tested for elevated blood lead levels at least once. Additionally, a child between the ages of 36 and 72 months must be tested for blood lead levels if they have not been tested before. The 2015 data available for the number of children (ages 0-18) on Medicaid was not available for this post. However, we do know a child in Michigan is automatically referred to the state’s Medicaid program if their family’s income is at or below 150 percent of the Federal Poverty Level.

It is particularly important children at risk of lead poisoning be tested because the substance is absorbed more into a child’s body than an adults. Additionally, a child’s brain and nervous system is more sensitive to the damaging effects of lead. Babies and young children can also be more highly exposed to lead because they often put their hands and other objects that can have lead from dust or soil on them into their mouths.

Michigan Lead Testing

Genesee County is where the city of Flint is located and in 2015 between 20 and 25 percent of Genesee County’s child population under the age of 6 was tested for elevated blood lead levels; more than 75 children under the age of 6 in just three zip codes within the city limits of Flint tested positive for elevated blood lead levels in 2015.

In response to the Flint Water Crisis, the State of Michigan has since “strongly recommended” that all children who live in the city, live in a home using Flint water or attend school or a childcare center in the city be tested for elevated blood lead levels. In addition, the state has required all children insured by Medicaid and/or enrolled in WIC be tested. These recommendations will certainly increase the percentage of children tested for elevated blood lead levels in Genesee County for the year of 2016.

Also, in a recent post we discussed how the city of Grand Rapids had one select zip code with 188 children under the age of 6 with elevated blood lead levels; in total there were no more than 523 children under the age of 6 in all of Grand Rapids with elevated blood lead levels. While the data on the percentage of children under the age of 6 tested for elevated blood lead levels in Grand Rapids in 2015 wasn’t readily available we do know that between 17 and 19.99 percent of children under the age of 6 in Kent County were tested for elevated blood lead levels.

The city of Adrian was another municipality discussed in a previous post because of the number of children with elevated blood lead levels. In 2015 there were 67 children under the age of 6 with elevated blood lead levels in Adrian, according to the Michigan Department of Health and Human Services. This number of children with elevated blood lead levels in Adrian contributed to the 10 percent of children under the age of 6 with elevated blood lead levels in Lenawee County. Subsequently, between 13.5 and 16.99 percent of children under the age of 6 were tested for elevated blood lead levels in 2015.

Although the areas mentioned above have been noted as having a high percentage of children under the age of 6 with elevated blood lead levels, none of the counties in which they are located in had more than 25 percent of children under the age of 6 tested for elevated blood lead levels. The counties in Michigan that did have more than 25 percent of its child population under the age of 6 tested for elevated blood lead levels were:

  • Jackson County
  • St. Clair County
  • Shiawasee County
  • Hillsdale County
  • St. Joseph County
  • Benzie County
  • Baraga County

The map above shows that elevated blood lead testing throughout the state of Michigan is inconsistent and 15 counties throughout the state had less than 13.5 percent of its child population under the age of 6 tested for elevated blood lead levels. We also know that children living in poverty have a higher risk of being poisoned by lead, but as the map shows, not all children under the age of 6 are being tested for lead poisoning, and of those not being tested there is certainly a portion of at risk children being excluded.

 

Lenawee County has highest percentage of children with elevated lead levels

The data discussed in this post is preliminary data on the lead poisoning of Michigan’s children in 2015 and was supplied by Michigan Department of Health and Human Services (MDHHS) at the county and zip code level, as well as data for the city of Detroit. At the county level, MDHHS also provided an approximate percentage of children who had blood lead levels at 5 ug/dL (micrograms per deciliter of blood) and above. Population data was only available by Zip Code Tabulation Area (ZCTA) (which are somewhat inconsistent with zip codes), preventing the calculation of percentage of children affected for the zip code data.

At 10 percent, Lenawee County had the highest percentage of its population under 6, county-wide, with an elevated blood lead level at 5 ug/dL, according to preliminary 2015 data supplied by MDHHS. The city of Adrian is located in rural Lenawee County and within the boundary zip code of 49221. There were 67 children under the age of 6 with elevated blood lead levels greater than or equal to 5 ug/dL in that zip code, according to data supplied by MDHHS.

The city of Detroit had 7.5 percent of its population of children under the age of 6 with elevated blood lead levels greater than or equal to 5 ug/dL . However, Wayne County (excluding Detroit) had less than 2 percent of its population of children under the age of 6 with elevated blood lead levels greater than or equal to 5 ug/dL. All seven counties in Southeastern Michigan had less than 2 percent of its population of children under the age of 6 with elevated blood lead levels. At the more local level though, the second map below shows that zip codes in the Port Huron area had between 55-99 children under the age of 6 with blood lead levels greater than or equal to 5 ug/dL. Portions of southern Oakland and Macomb counties, along with Ann Arbor/Ypsilanti area in Washtenaw County, had zip codes with no more than 14 children under the age of 6 with blood lead levels greater than or equal to 5 ug/dL. In Oakland County, the areas around Pontiac and Southfield, along with the area around the Detroit-Metro Airport in Wayne County had slightly higher numbers of children under the age of 6 with blood lead levels greater than or equal to 5 ug/dL; these numbers maxed out at 29, per zip code.

According to the Centers for Disease Control, 5 ug/dL is used a reference level by experts “to identify children with blood lead levels that are much higher than most children’s levels.” The CDC has recommended that public health actions be initiated in children under age 6 with blood lead levels above 5 µg/dL. Babies and young children can be more highly exposed to lead because they often put their hands and other objects that can have lead from dust or soil on them into their mouths.

Michigan Lead Data_County

Michigan Lead Data_Zip

When viewing the elevated blood lead levels in Lenawee County overall and at the more local level of zip codes, we see that the number of children under the age of 6 with elevated blood lead levels in Adrian contributed to the county as a whole having among the highest percentage of elevated lead levels. In 2015, according to MDHHS data, the zip code containing the city of Adrian had 67 children under the age of 6 with elevated blood lead levels.

Aside from Adrian, Detroit and the Port Huron area, the central portions of Muskegon County and Grand Rapids had substantial numbers of children with elevated blood lead levels in certain zip codes.

Adrian Lead Data

There were five zip codes in the city of Detroit in 2015 with more than 100 children under the age of 6 with elevated blood lead levels greater than or equal to 5 ug/dL. These zip codes were: 48238, 48204, 48210, 48209 and 48212. Four of these zip codes are aligned in a row on the west side of Detroit, including parts of neighborhoods such as Southwest Detroit. In total, 1,618 children under the age of 6 were reported to have elevated blood lead levels in Detroit in 2015.

Detroit Lead Data

In the southwestern portion of Grand Rapids the zip code of 49507 had 188 children under the age of 6 with elevated blood lead levels greater than or equal to 5 ug/dL. In total, the city had no more than 523 children under the age of 6 with elevated blood lead levels. The only other city with areas with numbers as high or greater was the city of Detroit, according to data supplied by MDHHS.

Grand Rapids Lead

The city of Flint is important when discussing elevated blood lead levels across the state of Michigan. Due to the water crisis that has been plaguing the city, children’s lead levels have gained national attention. The effect on children of lead in Flint’s water is unlikely to be correctly indicated by the 2015 numbers from MDHHS, first, because many children had not been tested, and second, because lead may not be found in their blood a certain amount of time after they quit drinking water containing lead. This is not to say the lead did not impact the children, but it may have been excreted or taken up into organs or bones. Many thousands of children may have been exposed to lead from the water, though the exact number is still unknown.

The 2015 data supplied by MDHHS shows that the highest number of children poisoned in Flint were in zip code 48503, which had 36 children under 6 with lead levels greater than or equal to 5 ug/dL. Portions of the zip codes of 48504, 48505, 48506 and 48507 are also within Flint’s city limits; these zip codes had 28, 15, 18, and 13 cases in 2015, respectively.

Flint Lead

While elevated blood lead levels in children in the city of Flint are being linked to lead found in the drinking water, as caused by the erosion of the city’s pipes, most lead poisoning in Michigan is related to lead in paint. In 1978, the federal government banned consumer uses of lead-containing paint, but some states banned it even earlier. Lead from paint, including lead-contaminated dust, is one of the most common causes of lead poisoning, and is almost exclusively the source of lead poisoning in the Detroit area, as discussed in a previous Drawing Detroit post.

Lead paint often deteriorates as housing ages, shedding dust and flakes, which becomes available to children to ingest. So the age of housing is a proxy for the risk of lead poisoning. The first map below shows that there are more than 50 counties across the state where 60 percent or more of the housing stock-either owner or renter occupied-was built prior to 1980. About 93 percent of all houses in Detroit and Flint were built before 1980, according to Census data. For the city of Grand Rapids 81.2 percent of the housing stock was built prior to 1980, and for the city of Adrian that percentage is 74.9. The second map below shows the percentage of renter-occupied housing units by county. It will require further examination for a conclusion about the statewide data, but certainly in Detroit lead poisoning tends to be higher in renter-occupied housing. This fact offers an opportunity in that it would be possible to use more assertive code enforcement to require landlords to abate lead paint hazards that are so pervasive in Michigan’s older housing. Several communities in Michigan have tested this approach, which has been very effective in other major cities.

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Renter 1980

Detroit Teen Pregnancy Rate Decreasing, Remains Above the Region’s and State’s

In 2014 in the seven county Southeastern Michigan region Wayne County had the highest teen pregnancy rate at 57.4 per 1,000 female residents between the ages of 15 and 19. This rate is largely reflective of the 84.8 teen pregnancy rate that Detroit had that year; without including Detroit into the calculation Wayne County had a teen pregnancy rate of 37.1 in 2014. And, while Wayne County had the highest teen pregnancy rate in the region in 2014 that rate was the lowest it had been since 1989. This trend of declining teen birth rates not only occurred in Wayne County, but throughout the seven county region, and in the city of Detroit.

According to the Michigan Department of Health and Human Services, the teen pregnancy rates discussed in this post were calculated by taking the estimated number of pregnancies, dividing that number by the female population of 15-19 year olds in each respective county and then multiplying that number by 1,000. Pregnancy numbers are a sum of estimated live birth, miscarriages and abortions. Information to calculate these numbers were provided to the Michigan Department of Health and Human Services through the Michigan Resident Live Birth Files, the Files of Induced Abortions Occurring in Michigan and the Michigan Division for Vital Records and Health Statistics.

Michigan Teen Pregnancy

In 2014 the Michigan Department of Health and Human Services reported there were an estimated 2,101 pregnancies amongst the 24,762 teens between the ages of 15-19 in the city of Detroit. As mentioned earlier, by excluding Detroit teen pregnancies from Wayne County the numbers significantly drop. This exclusion left Wayne County with a teen pregnancy rate of 37.1 in 2014, which is lower than St. Clair County’s pregnancy rate of 37.7 in 2014. St. Clair County’s pregnancy rate in 2014 is representative of a teen population of 5,011 females between the ages of 15-19, in which there were a reported 189 pregnancies. Only St. Clair and Wayne counties, along with the city of Detroit, had teen pregnancy rates above the state’s rate of 34.8 in the region. In Michigan in 2014 there were 330,141 females between the ages of 15-19; amongst this population there was an estimated 11,474 pregnancies. This produces a rate of 34.8

Washtenaw County had the lowest teen pregnancy rate in the region in 2014 at 14.2; this is representative of 213 estimated pregnancies amongst 15,510 females between the ages of 15-19.

Michigan Teen Pregnancy Historic

Overall teen birth rates in Southeastern Michigan have been declining; this is also a national trend. Wayne County, including the teen birth rate for the city of Detroit, consistently had the highest rate in the region. As for the lowest rate, it changed from Livingston County in 2005 to Washtenaw County in 2014. Additionally, while Wayne County had the highest teen birth rate in the region, it has also had the largest decrease of the seven counties. In 2005 the Wayne County teen birth rate was recorded at 76.5 and in 2014 that dropped to 57.4, a 19.1 decrease. In 2005 Washtenaw County’s teen birth rate was 28.2 (just above Livingston County’s rate at 24.9) and by 2014 it decreased to 14.2, making it the lowest teen birth rate in the region in 2014.

When not reviewing the teen birth rates solely at the county level we see that Detroit’s teen birth rates decreased from 107.8 to 84.8 between 2005 and 2014. This decrease was 23.8 points. While there was a decrease, Detroit’s pregnancy rates consistently remained above those in the seven county region. According to Michigan Planned Parenthood Communications Manager Julie McKeiver, both teen pregnancy, and abortion rates, tend to be higher in large cities and rural areas that have low income and low minority populations. This occurs because of the lack of access to health care and related services, she said. To help combat such high rates, Planned Parenthood of Michigan offers a Peer Education program in Detroit, which aims to educate teens on their sexual health. This education, according to McKeiver, is meant to empower the teens in the program, who will then share what they learned with their peers. This program is funded by the State of Michigan’s Taking Pride in Prevention Program (TPIPP). The TPIPP is statewide initiative that also aims to reduce pregnancy. The TPIPP not only funds the Detroit Peer Education Program but also the Safer Choices teen pregnancy curricula that Planned Parenthood implements in Detroit schools and community-based organizations, McKeiver said. This curricula touches on subjects such as delaying the initiation of sex and increasing the use of protection, according to the website.

Although programs are in place in Detroit that aim to decrease the pregnancy rate through education the question remains on how much impact those have versus the impact the lack of health care access that low income communities face.

Michigan Abortion Rates

In addition to teen pregnancy rates, the Michigan Department of Health and Human Services also tracks teen abortion rates. The city of Detroit had the highest rate at 26.3; there was a reported 652 abortions for the teen female population of 24,763 in 2014. When excluding Detroit, Wayne County had a teen abortion rate of 13; when including Detroit, Wayne County had a teen abortion rate of 18.7. The county with the next highest abortion rate was Macomb at 10.1; there were a reported 264 abortions for the 26,060 females between 15 to 19 in the county. The county with the lowest abortion rate was Monroe at 3.7. Michigan had a teen abortion rate of 8.6 in 2014 and the only other county in the region above that rate was Oakland County with a teen abortion rate of 8.8 ( 340 reported abortions for a population of 38,676).

The ability to view the abortion rates by county over a length of time was not made available by the Michigan Department of Health and Human Services. DrawingDetroit will continue pursuing these data.

Sexually Transmitted Infections (STI) in Southeastern Michigan: Chlamydia rate decreasing in Wayne County, but nearly double Michigan’s rate

In examining three major Sexually Transmitted Infections (STI) we find Chlamydia experienced rate increases in five of the seven counties in Southeastern Michigan between 2004 and 2014, according to the Michigan Department of Community Health. Oakland and Wayne counties were the only two that didn’t experience rate increases for this sexually transmitted infection (STI). These two counties were inline with the state trend; Michigan experienced a chlamydia rate decrease between 2004 and 2014, from 484.3 per 100,000 people to 452.5. According to the Centers for Disease Control, the increase in chlamydia rates was a national trend, as it increased about three percent from 2013 to 2014.

 

Chlamydia and gonorrhea were most commonly diagnosed in 15-24 year-olds throughout the country, according to the Centers for Disease Control. This is an ongoing national trend that a Centers for Disease Control Doctor Gayle Bolan said is occurring, in part, because of sexual relationships beginning at an early age, according to NBC News. Overall STI rates are increasing nationally because budget cuts to STI programs, changed behavior of gay and bi-sexual men and better reporting mechanisms, Bolan said. She said chlamydia is the most affected by better reporting mechanisms, as it has always been amongst the most common STI, while syphilis rates seem to be increasing because of the changed behavior of gay and bi-sexual men.

Also, officials from Rhode Island to Kent and Wood counties on Michigan’s west side are attributing their STI rate increases to “hook-up” apps like Tinder because of the increased opportunities they allow for casual sex.

 

In Michigan as a whole, not only are chlamydia rates decreasing, but so are gonorrhea rates; conversely, syphilis cases are increasing. This trend is similar with regional trends.

 

Chlamydia was the only sexually transmitted infection for which data were recorded for all seven counties at three time periods (2004-2008 average; 2009-2013 average and 2014). The sexually transmitted infection of syphilis has counties lacking data for all three time periods. Data on gonorrhea for all seven counties is available only for the 2004-2008 and 2009-2013 time periods. It is unclear if missing data is due to data suppression or low numbers.

All rates are per 100,000 residents.

Detroit Chlamydia Rates 2008

Detroit Chlamydia rates 2013

Detroit Chlamydia Rates 2014

St. Clair County experienced the largest chlamydia rate increase of all seven counties from a 2004-2008 average rate of 275.7 per 100,000 per residents to a 2014 rate of 402.4,. In 2014, though, it was Wayne County that had the highest overall Chlamydia rate per 100,000 residents at 811.1, a rate nearly 400 points higher than the states. The 2014 rate of 811.1 decreased from 1076.5 for the 2009-2013 average and from 1007.3 for the 2004-2008 average rate.

As noted earlier, Wayne and Oakland counties were the only two in the region to experience a rate decrease for chlamydia between 2004 and 2014. Oakland County’s average chlamydia rate for 2004-2008 was 300.5, and the 2014 rate was 280.7. Between the 2009-2013 average and 2014 Oakland County also experienced a rate decrease, from 297.6 to 280.7.

The state’s chlamydia rate for 2014 was 452.5, a decrease from 484.3 per 100,000 people for the 2004-2008 average and a decrease from 490.7 per 100,000 people for the 2009-2013 average.

Detroit Gonnorhea rates 2008

Detroit Gonnorhea rates 2013

Detroit Gonnorhea rates 2014

Between 2004 and 2014, of the counties with available data, Wayne County experienced the largest gonorrhea rate decrease from 376.6 for the 2004-2008 rate average to 231.4 for the 2014 rate per 100,000 people. Even so Wayne County had the second highest gonorrhea rate in the state in 2014 (Kent County had the highest rate at 255), according to the Michigan Department of Community Health, but the highest percent distribution of gonorrhea cases in the state came from Wayne County, with 42.4 percent of cases coming from there. The rate decreases for the other three counties with information available-Macomb, Washtenaw and Oakland-ranged between 9 and 15 points between 2004 and 2014. Washtenaw County’s 2014 gonorrhea rate was 72.9, decreasing from the 88.5 average from 2004-2008. Macomb County’s rate of 55.8 per 100,000 in 2014 was a decrease from the 64.7 average rate of 2004-2008. Oakland County’s 2014 rate of 49.6 per 100,000 was a decrease from the 78.7 average rate of 2004-2008.

St. Clair, Livingston and Monroe counties were missing rate data on gonorrhea for 2014. Between the 2004-2008 and 2009-2013 averages St. Clair and Monroe counties both experienced rate increases per 100,00 people and Livingston County experienced a rate decrease. For the 2004-2008 rate averages St. Clair County’s rate was 45, Monroe’s was 41.8 and Livingston County’s was 10.7. The 2009-2013 rate for St. Clair County was 46.6, Monroe 42.2 and Livingston County was 10.5.

 


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Detroit Syphillis Rates 2014

For syphilis data, Wayne, Oakland and Macomb Counties were the only three with consistent data between 2004 and 2014. According to the Michigan Department of Community Health, Wayne County had the highest rate of the three counties in 2014 at 32.4 per 100,000 people; this was an increase from 21.9 for the 2009-2013 average and an increase from 20.5 from the 2004-2008 average. Macomb County’s syphilis rate per 100,000 people in 2014 was 9 and Oakland County’s rate was 12.1. These two counties also experienced rate increases from the 2004-2008 average and the 2009-2013 average. For the 2004-2008 average, Macomb County’s rate was 5.6 and Oakland County’s rate was 7.6. For the 2009-2013 average, Macomb County’s rate was 7.5 and Oakland County’s rate was 7.8.

Washtenaw County had data recorded for the 2004-2008 average and the 2009-2013 average. This information that Washtenaw County’s rate between those two time periods experienced a miniscule rate increase, from 7.8 for the 2004-2008 average to 7.9 for the 2009-2013 average.

 

In 2014, Michigan’s syphilis rate was 11.3, an increase from both the 2004-2008 average (7.5) and the 2009-2013 average (7.6). The 2014 rate is nearly a third of Wayne County’s 2014 syphilis rate.

Cancer incidence rates declining across Southeastern Michigan

Overall cancer rates declined across all counties in Southeastern Michigan in the last decade. Cancer rates also declined for nearly all major categories—breast, colon/rectal, lung/bronchial and prostrate—in most counties. The category “all other sites” of cancer, however, increased between the 1998-2002 period and the 2008-2012 period for four of seven counties. These counties were Livingston, Macomb, Washtenaw and Wayne.

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For the total average cancer incidence rates per 100,000 people Monroe County had the largest decrease at nearly 100 between 1998 and 2012; the 1998-2002 average was 478.6 and the 2008-2012 average was 378.8. Oakland and St. Clair counties had similar rate decreases (73.8 and 84.1, respectively) between that time. For the 1998-2002 average Oakland County’s overall cancer incidence rate was 565.9, and St. Clair County’s rate for this time was 581. For the 2008-2012 averages, Oakland County posted a rate of 492.1 and St. Clair County posted a rate of 496.9.

From 477.6 to 471.9, Washtenaw County had the lowest decrease at 5.7. It was Livingston County that had the lowest average rate for 2008-2012 at 441.1 per 100,000 people; Livingston County’s average rate for 1998-2002 was 451.5.

For Wayne County, the average cancer incidence rate per 100,000 people was 568.2 for 1998-2002 and 525.5 for the 2008-2012 average.

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Livingston, St. Clair and Oakland counties all experienced a decrease in their average breast cancer rates between 1998 and 2012. From 1998-2002 Oakland and St. Clair counties had the highest breast cancer rates with Oakland County reporting a breast cancer rate of 84.6, and St. Clair County a rate of 83.7. St. Clair County had the largest decrease from the 1998-2002 to 2008-2012 average; the rate dropped 20.4 points, from 83.7 to 63.3.

Washtenaw County only experienced a 2 point decrease across those two time periods; it had the highest average rate for the 2008-2012 time period of 73.1.

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Average colon and rectum cancer incidence rates throughout the seven county region decreased between 1998 and 2012, with Monroe County posting the largest rate decrease. For the 1998-2002 average rate per 100,000 people Monroe County’s average incidence rate was 60.2, and for the 2008-2012 average the rate per 100,000 people was 35.8; the overall decrease was 24.4. For the 2008-2012 period St. Clair County had the highest average rate per 100,000 people at 51.6, though it had experienced a very substantial reduction from 74.2 in the 1998-2002 period.

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Lung and bronchus average cancer incidence rates in all seven counties decreased between 1998 and 2012, with St. Clair County experiencing the largest decrease at 17.3, from 90.1 to 72.8. Wayne County had the highest rate at 82.9 for 2008-2012, compared to 90.1 for 1998-2002.

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Monroe County had the largest average prostate cancer incidence rate decrease per 100,000 between 1998 and 2012 of 36.1; the 1998-2002 rate was 76.7 and the 2008-2012 rate was 40.6. Oakland County also experienced a large rate decrease from the 1998-2002 average to the 2008-2012 average; the Oakland County rates went from 104.7 to 79.4. Despite the 25.3 average rate decrease Oakland County’s average prostate rate remained the highest in the region for 2008-2012 at 79.4.

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When looking at all other average cancer incidence rates for the region four of the seven counties experienced rate increases per 100,000 people. Those four counties were Livingston, Macomb, Washtenaw and Wayne counties. Washtenaw County had the largest average rate increase at 15.1 per 100,000 between 1998 and 2012, from 216.4 to 231.5. Monroe County had the largest average incidence rate decrease between 1998 and 2012 at 22. Monroe County’s 2008-2012 average rate was 185.4, the lowest rate in the region, and its 1998-2002 rate was 207.4. Overall, Macomb County had the highest average incidence rate for 2008 to 2012 at 246.4; its 1998-2002 rate was 241.7.

Macomb County sees largest rate increases for drug-, alcohol-induced deaths

As with other regions Southeastern Michigan has rising drug-related death rates, which the Centers for Disease Control (CDC), have attributed to increased use and abuse of opioids. According to the CDC, opioid overdose death is an epidemic that can be found within even the quietest communities. In 2013, on the national scale, drug overdoses were the leading causes of injury death and 51 percent of those deaths were related to prescription drugs. While data at the county level on opioid specific deaths was unavailable, below are maps showing how drug-induced death rates have increased in every Southeastern Michigan county (where data is available) between 2003 and 2013. In addition to an increase in drug-induced death rates since 2003 there has also been an increase in alcohol-induced death rates and “all other causes” of death.

All of the information presented in this presented was obtained from the CDC. According to the CDC, data is unreliable if the number of deaths for a specific cause is too small to create an accurate rate. Additionally, some counties have suppressed rates, meaning the information obtained is below the determined “cut-off” value and the conditions for suppression are met, according to the CDC. Rates are per 100,000 residents.

Metro-Detroit Drug-induced Deaths 2003

Metro-Detroit Drug Induced Deaths 2013

Macomb County had the highest increase in drug-induced death rates between 2003 and 2013, with the rate climbing 16.2 per 100,000. In 2013 Macomb County had the second highest drug-induced death rate though at 29.2; Monroe County had the highest rate at 30.6. It was Washtenaw County that had the lowest drug-induced death rate in 2013 at 16.1; in 2003 the Washtenaw’s drug-induced death rate was 8.9.

In 2003 Monroe and St. Clair counties had too few drug-induced deaths (18 and 12, respectively) for reliable rates to be created. However, with such low drug-induced death numbers in 2003 for those two counties we can infer that Monroe and St. Clair counties also experienced an increase in their rates between 2003 and 2013, especially since the CDC was able to determine rates for 2013.

According to the CDC, those between the ages of 25 and 54 have the highest rate of opioid overdose deaths. While rates for drug-induced deaths at these age levels were not explicitly available, the data does show that Macomb County had 157 drug-induced deaths for residents between the ages of 25 and 54 in 2013. Monroe County had at least 20 such deaths, however numbers were not available for the 35-44 age group because the numbers were too small to report.

Metro-Detroit Alcohol Induced Deaths 2003

Metro-Detroit Alcohol Induced Deaths 2013

While there were fewer alcohol-induced deaths than drug-induced deaths in both 2003 and 2013 in each county with available data, there was still across-the-board increases between those dates. Of those documented rate increases, Macomb County again had the largest increase between 2003 and 2013 at 3.2. In 2013 Macomb County also had the highest alcohol-induced death rate of the counties in the region; this rate was 10.8.

Livingston, St. Clair and Washtenaw counties had to few of deaths for accurate rates to be presented.

Metro-Detroit Deaths 2003

Metro-Detroit Deaths 2013

As expected, the death rates for all other death throughout the region were much higher than either and both drug- and alcohol-induced death rates. One trend to note is that “other causes” death rates also increased between 2003 and 2013. St. Clair County had the largest increase at 184.9; its death rate in 2003 was 870.8 and in 2013 it was 1055.7. In 2013 St. Clair County had the highest rate and Washtenaw County had the lowest.

Just a few weeks ago we drilled down on how the death rate for white, middle aged population is increasing, largely in part to suicide and substance abuse. While numbers were unavailable for alcohol- and drug-induced death rates at the county levels for age groups, this post does highlight how deaths related to alcohol and drugs have been increasing over the last 10 years.

Basic Amenities Lacking in Southeastern Michigan’s Urban, Rural Communities

The basic amenities many of us take for granted – heating, plumbing, phone service, and full kitchens – are not accessible to everyone. There are occupied homes in Southeastern Michigan that lack one or more of these amenities. While a majority of occupied homes throughout the region do have a heating source, indoor plumbing, phone service, and a full kitchen, the maps below show that the communities with the highest percentage of homes that lack such amenities are typically located in the more rural and urban areas of the region, not suburban areas.

Slide10 Homes without Plumbing

Detroit homes without plumbing

In Southeastern Michigan in 2013, there were only two communities, Inkster (1.5 percent) and Northville Township (1.8 percent), where between 1.5 and 2 percent of occupied homes were without complete plumbing (lacking either a toilet, a bathtub or shower, and/or running water). At a national level, about 1.6 million people are without complete indoor plumbing, according to a 2014 Washington Post article.

In 2013, 1.2 percent of the occupied homes in the city of Detroit were without complete plumbing facilities and this equated to 93 different census tracts in the city having homes without some type of complete plumbing facility. According to a 2013 post titled “Still Living without the Basics in the 21st Century” from the Rural Community Assistance Partnership, those living in densely populated urban areas and sparsely populated rural communities are more likely to live in a home without complete plumbing facilities, particularly if they live below the federal poverty level. In a post earlier this year, we detailed how a majority of the census tracts in the city of Detroit in 2013 had 50 percent or more of its children living below the poverty line. We also know that the median income in the city was $26,325 in 2013, which fell $26,721 below the national median income.

Homes without heating sources

Detroit homes without Heating sources

In Southeastern Michigan, the highest percentage of occupied homes without a heating source, meaning they lack heating equipment, were located in the rural communities on the outskirts of the region. In total, there were four communities in the region (two in St. Clair County and two in Livingston County) where between 1.5 percent and 2.2 percent of occupied homes did not have a heating source.

While Detroit wasn’t one of the roughly 55 communities in the region where all occupied homes had a heating source, about 0.6 percent of occupied homes in Detroit were without one. A closer look at the city though shows that up to 33 percent of the occupied homes in some census tracts were without a heating source. There were 27 census tracts throughout the city where between 3 and 33 percent of occupied homes were without a heating source. Seven of these census tracts were located along I-96. Additionally, there were two other clusters of occupied homes – just south of Hamtramck and Highland Park and in the downtown area – with the highest percentage of homes with no fuel source.

For those homes throughout the region that do have a heating source, utility gas was the most common source, followed by electricity.

Homes without phone service

Detroit homes without phone service

In 2013, up to 8.2 percent of occupied homes in Southeastern Michigan lacked any type of phone service (cell and/or landline), according to the American Community Survey. Those communities with the higher percentages of homes lacking phone service were primarily located in the more urban areas of the region, such as Detroit, Highland Park, and Pontiac, and the rural areas, such as several communities located throughout St. Clair, Livingston, and Monroe counties.

There were eight communities in the region where all occupied households had phone service. Four of these communities were located in Washtenaw County, two were located in Oakland County, one was in Macomb County, and another was in St. Clair County.

The city of Detroit was one of the 32 communities where between 3.1 and 8.2 percent of homes lacked phone service. In total, 4.8 percent of occupied homes in the city were without phone service. A drill down into the city shows that nearly half of the census tracts had between 3 and 33 percent of occupied homes without phone service.

Homes without a full kitchen

Detroit homes without a full kitchen

Northville Township and the city of Chelsea were the only two communities in the region where more than 3.1 percent of occupied homes did not have a full kitchen in 2013. In Chelsea, 5.6 percent of the homes were without a full kitchen and in Northville that number was 3.3 percent. According to the Census, having a full kitchen means having a sink with a faucet, a stove or a range and a refrigerator.

 

The city of Detroit was one of 22 communities where between 1.1 and 2 percent of homes were without a full kitchen. In Detroit, 1.7 percent of occupied homes were without a full kitchen. When looking at Detroit at the census tract level though we see that in more than 50 census tracts up to 18 percent of occupied homes were without a full kitchen.

While access to a full kitchen, whether it be lacking a stove or refrigerator or both, is a true day-to-day problem for many people, sometimes an occupied home lacks a full kitchen because it is in the process of being remodeled.

Suicide, Substance Use Causing Increased Mortality Rates Among White, Middle-aged Men

Suicide rates are increasing and locally the number of suicides were either highest among those 20-44 or 45-74, as detailed in a recent Drawing Detroit blog post. According to a recent New York Times article, suicide is a cause of death that is not only growing in Southeastern Michigan, but nationally. Throughout the state of Michigan, according to the Michigan Department of Health and Human Services, suicide was the fourth leading cause of death for white males between the ages of 35 and 49 (244 suicides total).

The article details recent research conducted by Princeton Economists Angus Deaton and Anne Case, which concludes that the rising death rates among middle-aged white men are being caused by suicides and issues related to substance use. According to the article, the mortality rate for white Americans between the ages of 45 and 54 with no more than a high school education increased by 134 deaths per 100,000 people. While the Michigan Department of Health and Human Services does not detail mortality rates by race, age and education level explicitly on its website, it does show that the mortality rate from white males between the ages of 45 and 54 increased from 469.7 to 494.4 between 2000 and 2013. Just as the death rate for white American males is increasing nationally, Michigan is also experiencing the plight.

While suicide rates have contributed to the growing mortality rate for this segment of the population, Deaton and Case found that suicide coupled with deaths caused by drug use and alcohol poisoning are what explained the increased mortality rate.

No direct explanations were discovered for the increase in suicide deaths and deaths caused by drug and alcohol use, however, Deaton found that increases in mortality rates for middle aged white men were parallel with the same population’s reports on distress, pain and poor health. This correlation, he said, could be used a rationale for the increase in the type of deaths.

 

For more on this article click here.

To learn more about suicide rates in Southeastern Michigan click here.