Drug Deaths Continue to Increase in Metro-Detroit

According to the most recent data from the Michigan Department of Health and Human Services, drug-induced death rates are higher throughout Southeastern Michigan than alcohol-induced death rates. In 2016, according to the data, St. Clair County had the highest drug-induced death rate at 46.4 per 100,000 residents; Wayne County had the second highest rate at 41.4 per 100,000 residents. Regionally, Washtenaw County had the lowest rate at 20.8 per 100,000 residents. According to a recent New York Times article that focuses on 2017 data from the Centers for Disease Control, Michigan experienced more than a 10 percent increase in overdose deaths between 2016 and 2017, much of which can be attributed to synthetic opioids. The article states that with increased funding for public health programs related to mental health and substance abuse policies there is “optimism” that overdose death rates will at least begin to stabilize in the future. According to the Michigan Department of Health and Human Services, Michigan’s drug-induced death rate was 9 in 2000, having only continued to increase to 27.5 per 100,000 residents in 2016. All counties in the Southeastern Michigan region had seen similar increases in that time period as well.

While Wayne County had one of the highest drug-induced mortality rates in Southeastern Michigan, it had one of the lowest alcohol-induced mortality rates at 7.9 per 100,000 residents in 2016. The only other two counties in the region with lower alcohol-induced mortality rates were Oakland (7.4) and Washtenaw (7.7). St. Clair County had the highest alcohol-induced mortality rate at 16.3 per 100,000 residents in 2016.

Although the media attention has not been as high on alcohol-induced deaths as drug-induced deaths, a recent University of Michigan study did show that deaths related to cirrhosis (a liver disease often related to alcohol consumption) increased 65 percent between 1999 and 2016; it also stated there was a 10.5 percent increase in cirrhosis related deaths for 25-34 year olds.

Lake Huron has Highest Number of Beach Advisories/Closures

On July 8, 2018 there were 23 beach closures throughout the State of Michigan, three of which were in the Southeastern Michigan region. These were Newburgh Lake in Wayne County, Fox Lake in Oakland County and the Lake St. Clair Metropark Beach in Macomb County. Thus far in 2018, the Lake St. Clair Metropark Beach has been closed for a total of 25 days due to high bacteria levels, according to the Michigan Department of Environmental Quality (MDEQ). The earliest closure for Lake St. Clair Metropark Beach began on May 31, 2018 and lasted for three days. The most recent closure was announced on June 21, 2018 and it remains closed. According to the MDEQ, advisories or closures are most commonly issued due to elevated counts of E. coli in water samples collected from the shoreline of a water body. Health departments use the daily and 30-day geometric mean to determine if a beach closure or advisory should be issued; for E. coli that average is 300 milliliters. E. coli contaminations often occur from storm water, sanitary sewer overflow and wildlife (such as excrement left from Canadian Geese). Below are three charts showing the number of beach advisories/closures (formally referred to as actions) taken between 2012-2017 on beaches monitored along Lake Erie, Lake Huron, Lake Michigan, Lake St. Clair and Lake Superior. It is important to note that not all beaches along the Great Lakes (and Lake St. Clair) are monitored. Local health departments and non-profits receive federal and state grant funding to monitor beaches. Monitoring must occur on beaches for which grant funding is provided for. The first chart below shows the percentage of monitored beaches across the state that had an advisory between 2013-2017. The highest percentage of actions occurred in 2015 at 25 percent; most recently the percentage of actions reported in 2017 was 18 percent. The 10-year average was 21.5 percent.

When looking at the sheer number of actions by lake, Lake Huron has regularly had the most number of advisory/closures since 2013, according to the Michigan Department of Environmental Quality. In 2017, 18 were reported, a decrease from the high of 29 in 2015.

The final chart below details the number of closures and advisories issued for Lake St. Clair Metropark, due to its regularity of closures compared to other monitored beaches in Southeastern Michigan. As noted earlier, Lake St. Clair Metropark often has a Canadian Geese problem, and it is regularly noted in media outlets that the excrement from these birds contribute to the high E. coli levels in the water samples. To deter the number of geese at the beach, the Metropark has enlisted the help of three dogs to chase away the geese.

As the St. Clair Beach Metropark takes steps to deter a contributor to its closures, the State also began using a rapid testing method to identify E. coli contamination faster. The method identifies and measures E. coli DNA and provides results on the same day it is collected; the more traditional method provides results up to three days later. Currently, according to the MDEQ, there are 12 labs in the state able to perform this method.

Majority of Medical Marijuana Shops Close Throughout Detroit

More than 200 medical marijuana caregiver centers have closed throughout the State of Michigan in the last several weeks, the majority of those being located in Detroit. According to data provided by the City of Detroit, as of March 23, 194 medical marijuana caregiver centers have closed in the City in 2018. Of these, 159 of medical marijuana caregiver centers closed between March 15 and March 29; these centers closed following cease and desist letters sent by the Michigan Department of Licensing and Regulatory Affairs (LARA) due to the fact they didn’t apply for licensing through the state. Centers had been allowed to stay open through an emergency rule that was issued in December stating, if the business had approval from the municipality it was located in and applied for the required LARA license. According to multiple media sources, the letters sent by LARA to the 200 plus medical marijuana caregiver centers stated if the centers did not close they would be at risk of not being able to obtain future licensing and/or face consequences from law enforcement.

Currently in Detroit there is a moratorium on new medical marijuana caregiver facilities opening; it went into affect on Feb. 13 and will last for at least six months. Despite the moratorium and closings there are still medical marijuana caregiver centers in Detroit. The first map below shows where all the medical marijuana caregiver centers in Detroit (368) are or were located, including those that have been closed in 2018, and those that are still operating and/or seeking licensing (57 still operating and/or seeking approval and 98 simply seeking approval). While the centers are spread out throughout the City, there were certainly areas with higher concentrations of the centers. For example, right along the northern border of Detroit, 8 Mile Road, there were about 55 medical marijuana caregiver centers. Gratiot Avenue is also heavily lined with medical marijuana caregivers. While majority of centers, both open and closed, are located north of Detroit’s downtown, there are a handful in Detroit’s inner core.

The second map shows the 194 medical marijuana centers that have been closed in 2018. As stated, that is 194 out of 368 in the City (the 368 includes those that are operating, those that are seeking approval and those that are closed). The centers that have closed in the City are not concentrated in specific neighborhood.

There are 13 medical caregiver facilities in the City (shown in the map below) that are operating the closest to compliance as possible, within the expectations of local and state laws, because they have received zoning approval from the City of Detroit and have applied for the emergency licensing described above. According to two initiatives passed on Nov. 7, 2017 in Detroit the Zoning Board of Appeals does not have the authority to review dispensary applications and allows these businesses within 500 feet of several organizations, including religious institutions and other dispensaries. The City has since challenged these initiatives, further confusing the legal operation of medical marijuana caregiver facilities in the City, and the zoning regulations related to them.

In addition to Michigan Medical Cannabis Commission medical marijuana caregiver facilities and those that have closed, there are also the ones that are in the approval process and ones that are in the approval process and still operating. The first map below shows that there are 57 medical marijuana caregiver facilities and/or currently operating in the City of Detroit. While the City of Detroit doesn’t detail what “and/or still operating means,” it is likely related to the facilities that applied for emergency licensing to remain open during the time their new licensing through the state was being reviewed. In addition to the 57 facilities that are seeking licensing and/or still operating, there are an additional 98 medical marijuana caregiver facilities (second map below) seeking approval from the City and the State that are not operating.

In traversing through this issue for this post, it is evident there is still plenty of work to be done at the local and state level to eliminate confusion and allow medical marijuana caregiver facilities to operate legitimately. Like Detroit, other local governments are also trying to navigate through state and local regulations. For example, in Ann Arbor new zoning regulations were approved by the City Council in February. Zoning for four dispensaries in Ann Arbor was then approved, while decisions on two others were delayed. Local officials there too are still learning how to adjust.

Monroe’s Water Lead Levels Highest in Southeastern Michigan

In 1991 the Lead and Copper Rule was implemented by U.S. Environmental Protection Agency as a means to help prevent exposure to lead and copper. According to the rule, if lead concentrations in drinking water exceed 15 parts per billion (ppb) in more than 10 percent of customer’s taps sampled, additional controls must be taken to prevent corrosion. According to a recent MLive article, which compiled Michigan Department of Environmental Quality lead testing data from water systems throughout the State of Michigan, the City of Monroe was the only public water system in Southeastern Michigan that had lead levels that reached the federal threshold. According to the data, which states testing ended on Dec. 31, 2016, the City of Monroe’s 90th percentile for lead was 15 ppb. For comparison, the data showed that between January and June of 2017 Flint’s 90th percentile for lead was 7 ppb.

In Southeastern Michigan, there were only three public water systems (for which data was available) with lead concentration levels above Flint’s. Those systems were located in:

  • Grosse Pointe Shores: 9 ppb
  • Capac: 7ppb
  • Marysville: 12 ppb

Conversely, there were 77 public water systems in Southeastern Michigan for which data was available, with zero lead tested in the water system.

While the data shows the lead levels are improving in Flint, this data also shows how the region’s, and the state’s, water systems need continuous monitoring and the infrastructure needs regular maintenance. According to a Brookings article (link), the federal government is only responsible for less than a quarter of the spending on all 51,000 plus public water systems in the country. This means, local and state governments must bare the brunt of the cost to ensure citizens have access to a clean, reliable water source. In Southeastern Michigan, a large portion of the region’s water system is overseen by the Great Lakes Water Authority. This government agency is regional authority that was created to ensure larger purchasing power is available for infrastructure improvements. This is one step the region has taken in recent years to ensure clean water remains available to the residents of Southeastern Michigan.

Food Least Accessible for Detroit in Southeastern Michigan

Throughout Southeastern Michigan the City of Detroit had the highest number of Census tracts with the lowest access to food sources, according to 2015 data from the U.S. Department of Agriculture (USDA). For the purpose of this post, low income is defined as Census tracts with a poverty rate of 20 percent of higher or with a median family income less than 80 percent of median family income for the state or metropolitan area. Areas with low access to food are identified as Census tracts having 33 percent of the population living within a certain mileage from a grocery store. In this post these areas are identified by either being a half-mile or mile from a grocery store in an urban area and 10 miles in a rural area (these differences are identified in each map below). According to the USDA, none of the counties and/or Census tracts in Southeastern Michigan are identified as rural, so the 10 mile rural identifier will not be used in this post.

Half-mile  Mile

When examining the Southeastern Michigan region for the number of Census tracts with low-income families and low access to food sources within a half-mile majority of the City of Detroit is highlighted in the map below, in addition to Hamtramck and Highland Park. There were also several Census tracts just outside the border of Detroit, in areas including Warren, Eastpointe, Dearborn, Hazel Park and Southfield, that had low incomes and low access to reliable food sources. While there were several Census tracts in every one of the seven counties in the Southeastern Michigan region, it was Wayne County that had the had the highest number of residents with low incomes and low access to grocery stores within a half-mile of residents’ homes.

A closer look at just the Census tracts in the City of Detroit show that there were only a select number of pockets in the City that were not considered low income and also had access to a grocery store closer than a half-mile. One such area that stands out is the downtown area. Other areas include the Denby, Cody Rouge and West Village neighborhoods.

In Washtenaw County, it was the Ann Arbor/Ypsilanti area that had the highest number of Census tracts with low-income families not having access to grocery stores and in Oakland County, beyond those Census tracts that border Detroit, it was the Pontiac that had the most number of low-income residents with low access to food options. In the less densely populated counties in the region (Monroe, St. Clair, Livingston) there was an average of about three Census tracts with a poverty rate of 20 percent of higher or with a median family income less than 80 percent of median family income and access to a grocery store more than a half-mile away.

One Mile

When the radius was expanded to one mile, the number of Census tracts without access to grocery stores dramatically decreased. The most notable decrease in the region was in the City of Detroit. In the maps below there are only about 20 Census tracts in the City of Detroit with a poverty rate of 20 percent of higher or with a median family income less than 80 percent of median family income and access to a grocery store more than a mile away. In the maps above, which depict access within a half-mile, nearly the entire City is highlighted for low income and low access. A notable difference due to access between a half-mile and mile can also be seen in the Ypsilanti/Ann Arbor area.

Throughout Livingston, Monroe and St. Clair counties there was a minimum decrease in the number of Census tracts with a poverty rate of 20 percent of higher or with a median family income less than 80 percent of median family income and access to a grocery store more than a half-mile away.

Low Income and Low Vehicle Access

The maps below identify low-income Census tracts where more than 100 housing units did not have a vehicle and were more than a half-mile from the nearest grocery store. When applying these variables we see there was an overall fewer number of Census tracts without access than when only looking at access, despite transportation accessibility. This was particularly true throughout Wayne County and in Census tracts just north of Wayne County. In Detroit, the highest concentration of Census tracts with more than 100 housing units not having a vehicle and that were more than a half-mile from the nearest grocery store were those on the west side of the City along Livernois Avenue.

In examining the data provided by the USDA, we see that regionally it was the City of Detroit, its inner-ring suburbs that had the highest number of low-income families with among the lowest access to food due to the location of grocery stores in 2015. To help support access to grocery stores, a robust public transportation network could be one solution, particularly in Detroit and its surrounding cities. Additionally, it is also important to understand the impact low incomes have on families when it comes to accessing healthy foods. While grocery stores may be within a half-mile or mile from a home, once an individual reaches a grocery store the chances of them purchasing fresh, non-processed foods may not be as high due to cost, and quite possibly access within the store. To support access to fresh foods in urban areas like the City of Detroit the Detroit Food Justice Task Force recommends policies that allow for more support of neighborhood famers markets and small businesses and research that identifies the food needs of neighborhoods throughout the City.

Maternal Deaths Highest in Detroit

A look into the pregnancy related death rates in Southeastern Michigan showed that the City of Detroit had higher rates from 2008-13 (combined) than any other governmental unit reported for the region. The Michigan Department of Health and Human Services says pregnancy related deaths are those when a woman dies while pregnant or within one year of pregnancy from any cause related to, or aggravated by, pregnancy or its management. According to MDHHS data, the pregnancy related death rate for Detroit was 44.4 per 100,000 babies from 2007-13 (44.4 total). Pregnancy associated deaths, by contrast are those that occur while a woman is pregnant or within a year of pregnancy irrespective of cause; these deaths can include suicide, drug overdoses or medical causes such as cancer. The rate for Detroit was 62.7 per 100,000 babies for pregnancy associated deaths (48 total) from 2007-13. When comparing pregnancy associated deaths and pregnancy related deaths, the data shows that there were overall higher rates for pregnancy associated deaths. This is likely because pregnancy associated deaths encompasses a broader range of causes of death.

As stated, the data provided by the Michigan Department of Health and Human Services shows that Detroit had the highest rate of pregnancy related death and pregnancy associated death rates in the region. For pregnancy related deaths, Wayne County had the lowest rate at 9.5 per 100,000 babies (9 total), for the counties where data were available. Wayne County’s rate excludes the deaths in the City of Detroit. In Southeastern Michigan pregnancy related rates for Livingston, Monroe, St. Clair and Washtenaw counties were not available because there were five or less deaths.

For pregnancy associated deaths Oakland County had the overall lowest rate at 28.6 (7 total). In Southeastern Michigan, pregnancy associated rates for Livingston, Monroe and Washtenaw counties were not available because there were five or less deaths.

According to an article from the Detroit News, high maternal death rates are related to chronic health conditions and high rates of poverty, both of which are common in Detroit.

The Michigan Department of Health and Human Services does not have data for 2014 and 2015 because it had not been reviewed by the State’s maternal death committees, as of early December, according to a representative from the department. In early 2017, Public Act 479 of 2016 was signed into law making maternal death reporting mandatory. Prior to this law reporting was voluntary.

Lead Poisoning in Detroit, 2016

Lead poisoning has long been a serious problem for Detroit’s children, producing a lifetime of reduced cognitive capacity and many other consequences. In 1998, 17,015 Detroit children under 6 years old were lead poisoned at or above the 5 micrograms of lead per deciliter of blood (ug/dl) level. For over a decade lead poisoning has been declining yeay-by-year, but in 2016, the number rose by over 400 children to 2,073 (Figure 1). This was over 27 percent increase in one year (Figure 3).

It is likely that the proximal cause of this rise was an increase in testing of children. As shown below (Figure 2), testing had been declining in Detroit in recent years through 2015. In 2016, testing of children shot up by 9.5 percent (Figure 3). Over 2,000 more children were tested during this time. This was for two clear reasons. First, the Flint crisis surrounding lead in drinking water triggered more parents to have their children tested. Second, the City of Detroit, emerging from bankruptcy, was rebuilding its Health Department, and that agency began to actively test for lead and to encourage others to do so as well.

While, the percentage of children with lead poisoning has recently increased, the numbers are not evenly distributed across Detroit (Figure 4 below). Rather, children with lead poisoning are concentrated in zip codes where there are many older houses, mostly built well before the 1940s when lead paint was used frequently in homes. Second, these zip codes have low medium incomes (recall that poverty has increased in Detroit), and residents cannot afford to maintain their homes or landlords choose not to do so. Third, there are still many children in these zip codes.

So, many children are exposed to fraying homes where lead paint was heavily used historically. In one of these zip codes, 48214, preliminary data from a sample of over 500 homes indicates that as many as 87.9 percent of the homes assessed have some lead present on windows, walls, floors or porches. In this same zip code, tests show that about 17 percent of children have lead poisoning. The zip code with the highest percentage of children with lead poisoning is 48206 at 22.3 percent.

So, what can be done? Three important strategies are being executed by the City and others.

  • First, the Health Department attempts to case manage lead poisoned children, making sure that their home gets assessed and parents are trained to protect the child. Early intervention may reduce the long term effects of poisoning.
  • Second, where feasible, the homes of these children are referred for lead abatement, a procedure where lead hazards are removed from the home using public dollars, where the household cannot afford to pay. This can be very expensive, ranging from $5,000 to over $20,000. Still this costs a lot less than the lifetime cost of lead poisoning for a child.
  • Third, the City recently passed amendments to its property maintenance code that requires landlords to remove lead hazards from homes that they rent. In effect, this requires them to remove lead hazards. The City will be ramping this strategy up over the next few years, and this is expected to help the over 50 percent of Detroit residents who now rent.

Two more strategies are emerging as well:

  • First, ClearCorps and The Wayne State Center for Urban Studies are piloting an effort to identify homes with lead where children reside. Through this process an abatement of early lead hazards will take place, removing the hazard of a child being lead poisoned. The challenge for this approach is whether enough abatement funds and contractors to do the work can be made available for these homes.
  • Second, another possibility is to help families, who might choose to do so, to relocate to areas where homes have little or no lead paint. As Figure 4 above shows, several of the northern and western zip codes of Detroit have relatively low levels of lead poisoning of children. Figure 5, below, shows the percentage of tested children identified as lead poisoned for all of Wayne County. Figure 6 shows Oakland County. Figure 7 shows Macomb County. Many of these zip codes have no reported lead poisoning cases, but some of the housing may be prohibitively expensive for current Detroit residents.

Southeastern Michigan Drug Death Rates On The Rise, Trend Similar to State and Nation-wide Problem

Between 2010 and 2015 Wayne County experienced the largest rate increase for drug-induced deaths in Southeastern Michigan, according to the Michigan Department of Community Health. In 2010 the rate for drug-induced deaths in Wayne County was 22.4 per 100,000 people and by 2015 that increased to 36.1 per 100,000 people. In Detroit, the drug-induced death rate increased by 9.4; in 2010 the rate was reported at 22.3 per 100,000 people and in 2015 it was reported to be 31.7 per 100,000 people.

Monroe County was the only other in the region to experience an increase above 10 per 100,000 between 2010 and 2015 was Monroe County. In 2010 the drug-induced death rate in Monroe County was 19.7 per 100,000 people, and by 2015 it had increased to 32.1 per 100,000 people, meaning there was a 12.4 rate increase.

In addition to showing rate changes between 2010 and 2015 we have also created maps that show the rate changes in five-year increments between 2000 and 2005 and 2005 and 2010. Between 2000 and 2005 Monroe County was the only county in the region to experience a rate increase above 10. In 2000 the drug-induced death rate in Monroe County was reported at 4.1 per 100,000 people and by 2005 increased to 17.1 per 100,000 people. Between 2005 and 2010 the rate increase for Monroe County was much smaller at 2.6, however the data shows drug-induced death rates in Monroe County and throughout the region have continued to increase since 2000.

Between 2000 and 2015 the overall drug-induced death rate increase for Monroe County was 28, and for Wayne County that rate increase was reported at 18.2. In 2000 the drug-induced death rate in Wayne County was reported to be 18.2 per 100,000 people, by 2005 it increased to 22 per 100,000 people. Between 2005 and 2010 there was a slight rate decrease of .3, but by 2015 the rate peaked at 36.1 per 100,000 people (the highest in the region).

Also between 2005 and 2010 in Detroit there was a drug-induced death rate decrease; this decrease was reported at 3.7 (in 2005 the rate was reported at 26 and in 2010 it was reported at 22.3). However, like the seven counties in the region, Detroit experienced drug-induced death rate increases between 2010 and 2015 of 9.4 per 100,000 residents, and overall since 2000 an increase of 9.1.

An overall increase in drug-induced death rates is not unique to Southeastern Michigan. According to the Michigan Department of Community Health, 2015 was the third straight year the State of Michigan experienced an increase in the drug-induced death rate. In 2015 the rate was reported at 22.3, compared to a rate of 20.5 in 2014, 18.3 in 2013 and 16.4 in 2012. Throughout the country, according to a recent Free Press article, there were 19 states (Michigan being one of them) that experienced an increase in drug-induced death rates. The U.S. Centers of Disease Control and Prevention reported that of the 52,404 drug overdose deaths in 2015, 63 percent of them were related to opioids. In Michigan, according to the Free Press article, about 45 percent of the drug related deaths in the state were related to opioids and about 20 percent involved heroin.

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.