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.

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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.

Southeastern Michigan’s Firearm Deaths Ruled Suicide Surpass those Ruled Homicide, Accidental

In Detroit, homicides by firearm far outpace suicide, according to the Michigan Department of Health and Human Services 2013 data. Outside Detroit in each of the seven counties in the region, the reverse holds. Suicide by firearm far exceeds homicide by firearm. Accidental deaths by firearm in Southeastern Michigan in 2013 were far lower than either other category. Wayne County, excluding the city of Detroit, had the largest difference between firearm deaths ruled suicide and firearm deaths ruled homicide; there were 50 more firearm deaths ruled homicide. Macomb County had the second largest difference at 42 and Oakland County’s difference was 39.

In Detroit there were 214 more firearm deaths ruled homicide than suicide.

Firearm deaths ruled accidental was the category with the lowest numbers across the region. Wayne County had the highest number of accidental deaths at three while Livingston, Oakland and Washtenaw counties, along with the city of Detroit, had zero.

When looking at the rate of suicide and homicide deaths by firearm per 100,000 residents we see that suicide had a higher rate in all counties but Wayne in 2013. However, when the number of Detroit suicide and homicide deaths are removed from Wayne County it was in line with its peers in that its rate of suicide death by firearm was higher than its rate of homicide by firearm. At the county level, Macomb County had the highest rate of suicide by firearm at 7.6 and Livingston County had the lowest at 2.7. When not including the Wayne County rate of homicide by firearm with Detroit numbers included, Oakland County had the highest rate of homicide by firearm per 100,000 residents in 2013 at 2.5.

Detroit’s rate of homicide by firearm per 100,000 residents was higher than its suicide rate by firearm though in 2013; the rate of homicide by firearm was 13.6 while the suicide rate by firearm was 4.7.





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Southeastern Michigan Firearm Deaths

Rate of Suicide by Forearm

2013 Firearm Homicides

In Detroit, homicides by firearm far outpace suicide, according to the Michigan Department of Health and Human Services 2013 data. Outside Detroit in each of the seven counties in the region, the reverse holds. Suicide by firearm far exceeds homicide by firearm. Accidental deaths by firearm in Southeastern Michigan in 2013 were far lower than either other category. Wayne County, excluding the city of Detroit, had the largest difference between firearm deaths ruled suicide and firearm deaths ruled homicide; there were 50 more firearm deaths ruled homicide. Macomb County had the second largest difference at 42 and Oakland County’s difference was 39.

In Detroit there were 214 more firearm deaths ruled homicide than suicide.

Firearm deaths ruled accidental was the category with the lowest numbers across the region. Wayne County had the highest number of accidental deaths at three while Livingston, Oakland and Washtenaw counties, along with the city of Detroit, had zero.

When looking at the rate of suicide and homicide deaths by firearm per 100,000 residents we see that suicide had a higher rate in all counties but Wayne in 2013. However, when the number of Detroit suicide and homicide deaths are removed from Wayne County it was in line with its peers in that its rate of suicide death by firearm was higher than its rate of homicide by firearm. At the county level, Macomb County had the highest rate of suicide by firearm at 7.6 and Livingston County had the lowest at 2.7. When not including the Wayne County rate of homicide by firearm with Detroit numbers included, Oakland County had the highest rate of homicide by firearm per 100,000 residents in 2013 at 2.5.

Detroit’s rate of homicide by firearm per 100,000 residents was higher than its suicide rate by firearm though in 2013; the rate of homicide by firearm was 13.6 while the suicide rate by firearm was 4.7.

There were four counties with an increase in the percentage of firearm deaths ruled suicide between 2008 and 2013. Monroe County had the largest increase at 1,000 percent, which is representative of an increase of 10 firearm deaths ruled suicide. In 2008 there was one suicide in Monroe County and in 2013 there were 11. The other three counties were Washtenaw, Oakland and Macomb. In terms of sheer numbers, Oakland County had the largest increase of firearm deaths ruled suicide between 2008 and 2013 at 27.

Livingston County had the largest percentage decrease of firearm deaths ruled suicide between 2008 and 2013 at 55 percent. In 2008 in Livingston County there were 11 firearm deaths ruled suicide and in 2013 there were 5.

Change of Gun deaths

Livingston, Macomb, St. Clair Counties’ Suicide Rates Top Those Of State, Nation

Nationally, the suicide rate was 12.1 suicides per 100,000 residents in 2013, according to the Centers for Disease Control, and statewide it was 12. 9 per 100,000 people, according to the Michigan Department of Health and Human Services. However, in Southeastern Michigan we had three counties—Livingston, Macomb and St. Clair—that exceeded this rate. Livingston County had the highest rate in the region at 15.4 per 100,000 residents, with 28 suicides in the county in 2013. Macomb County had the second highest rate 14.8 (125) and St. Clair County had the third highest rate at 13.6 (22) in the region. In the seven counties throughout the region, and in the state overall, suicide was ranked as one of the top 10 causes of death in 2013.

While only certain cities throughout the region had suicide numbers available through the Michigan Department of Health and Human Services, we do know that Detroit had the largest overall number of suicides at 57 and Warren had the second highest number at 34; these are the first and third largest cities in the state, therefore when looking at total numbers (not the rate) it is not unexpected that they would also be the highest. The Detroit rate is below the state rate, however, at 12.3.

Southeastern Michigan Suicide Rate

Number of Suicides

Suicides by city

Nationally, the suicide rate was 12.1 suicides per 100,000 residents in

Suicide rates have been climbing at the state-level and in areas throughout the region. Michigan’s suicide rate is currently the highest it has been since at least 1980 (the first year this data is accessible online), according to the Michigan Department of Health and Human Services. From the 2004-2013, Macomb County had a suicide rate higher than that of the state for seven out of 10 years. In 2013, Macomb’s suicide rate was 14.8, an increase from 11.4 in 2004. Oakland County’s rate increased from 9.9 to 12.3 during that time frame (peaking at 13.9 in 2012), and Wayne County’s rate increased from 9.3 to 11.5 between 2013 and 2014.

In Oakland County, the rate peaked at 12.9 in 2012 and only slightly decreased to 12.3 in 2013. Director of Clinical Services for Health Management Systems of America Beth Combs cited the recession as one of the reasons for the national suicide rate climbed in the past 10 years, according to a 2013 Oakland Press article. She said the loss of a job, particularly for men between the ages of 35 and 55, can leave many feeling hopeless. However, a struggling economy does not solely cause one to take their own life, if at all. Suicide can be caused by mental health issues, feelings of hopelessness and/or loneliness, divorce, bullying, violence and several other issues, according to the Michigan Association for Suicide Prevention.

Annual rates for Livingston, Monroe, St. Clair and Washtenaw counties were not included in the below graph because the Michigan Department of Health and Human Services only had five year rolling averages for those counties.

Suicide rates over time

Suicide rates by age group

The suicide rate has nearly doubled for middle-aged Americans in the past decade, according to an Oakland Press article. Above we see that throughout Southeastern Michigan counties in 2013, the number of suicides were either highest among those 20-44 or 45-74 (this is how age categories are broken down by the Michigan Department of Health and Human Services). Livingston, Macomb and Wayne counties had the highest number of suicides in the 20-44 category while Monroe, Oakland, St. Clair and Washtenaw had the highest number in 45-74 category. At the national level, according to the Centers for Disease Control, the age group with the highest suicide rate (19.1) was those between the ages of 45 and 64.

According to the American Foundation of Suicide Prevention, adolescents consistently have lower suicide rates than other age groups.

 

In Michigan, while support groups for those suffering from suicidal thoughts and survivors of suicide do exist, mental health funding as a whole has been cut. In 2014, according to a Voice News article, Macomb County cut services to about 1,300 people and St. Clair County cut services to about to about 300. Overall, about $100 million was cut from the state’s mental health system in fiscal year 2014. In Macomb County, due to the state and Medicaid funding cuts, the county’s mental health authority cut its Survivors of Suicide (SOS) program and must rely on volunteers to staff its crisis center. Through general fund appropriations Macomb County has been able to re-establish the SOS program by contracting with an outside party. The Oakland County Community Mental Authority has taken a different route to promote suicide awareness prevention and support by a securing a five-year, $200,000 grant from the Substance Abuse and Mental Health Service Administration.

Despite monies being found outside of state funding to support suicide prevention, support and awareness programs we must be aware that rates are increasing locally and throughout the state as state funding for mental health services is declining.

Refocusing Housing Policy in Detroit: Moving to Healthy Housing

The majority of families in Detroit face the risk of death, injury, illness and loss of their children’s mental capacity every day because of hazards in their homes. Based upon highly detailed analyses of homes, it is clear that homes are causing burns, falls, asthma, allergies and lead poisoning.

A detailed survey of Detroit homes, conducted by the Center for Urban Studies at Wayne State University, found that over 62 percent of nearly 500 randomly selected homes have at least one high risk hazard that is likely to lead to poor health outcomes. [1] Of these, 4.2 percent of the homes have three or more hazards in these high risk categories. These dangerous housing conditions, combined with high unemployment and continued crime, are driving people to leave the city in droves.

Recent estimates show Detroit is continuing to lose residents at fast clip, about 1,155 residents[2] a month.

The City is working hard on unemployment (and the improvement of the economy as a whole is helping) and on increased and smarter policing. But on housing for existing residents, far more needs to be done, not just by the City, but by the State and the Federal Government.

To stop this decline and avoid the health consequences of dangerous homes, Detroit and policy makers need to focus far more efforts on providing safe and healthy homes.

As of July 2014, Detroit had a total of 252,173 occupied housing units.[3] However, our best estimates—very generous–are that only around 500 a year are being substantially improved to make them healthy and safe places to live, while just over 800 new housing units were built last year.[4] This is an estimated total of 1,300 homes being produced per year. At this pace, it will be many decades before vast majority of Detroit’s residents can live in safe and healthy homes.

What is a reasonable goal for creating healthy homes for Detroit’s children? A modest goal would be to house all of Detroit’s 193,150 children[5] in safe housing within 10 years. Approximately 3 percent of households (or around 6,000 children) already reside in housing built later than 1980[6] and, in most cases, this is relatively safe housing.[7] A total of about 79,400 households with children live in pre-1980 housing, and we estimate 38 percent are in houses that have only minor hazards[8]. That means 49,259 households are living in homes where one or more major hazard puts them at risk every day. Having nearly 50,000 households plagued with one or more hazards is unacceptable, which is why the families residing in these homes need either new or rehabilitated housing, and they need it soon.

Within 10 years—a short time in the policy world—policy makers should be able to address these needs. To avoid deaths, injuries, illness and loss of mental capacity caused by home environments, Detroit needs at least 4,900 new or rehabilitated homes a year. That is 3.8 times the number we estimate that is being produced now. And this is only the number necessary to protect families with children, not other vulnerable populations such as the elderly.

We need to massively expand renovation and construction, specifically, in these ways:

  • First, concentrate on housing with children, the most vulnerable among us, for rehabilitation;
  • Let’s give families with children a priority to relocate to subsidized housing that has been built after 1980 or that has been re-built and remediated, including lead abatement.
  • Make homes healthy through small investments. Some homes can be made healthy for an investment of substantially less than $5,000. The Green & Healthy Homes Initiative Detroit-Wayne County has shown this can be done. We need to do more of this.
  • Work to improve and remove hazards from current houses, rather than new construction. In cases where the abatement of lead hazards is necessary, the work can cost an average of $20,000,[9] still a fraction of the cost of a new construction.
  • Use code enforcement to force rental owners to substantially improve homes. Progress is being made here, but the number of code inspectors, cut sharply in the midst of Detroit’s fiscal difficulties, needs to be expanded substantially.
  • Ensure all new construction in Detroit includes affordable units.
  • Increasingly the private sector is rehabilitating homes in Detroit. These rehabilitations should pass all standards, especially including the removal of asbestos and lead-based paint. Currently, private sector rehabilitations do not have to pass all standards among governmental and lending organizations that control the sale and rehabilitation of many of these homes.
  • Leverage local and state resources, ranging from public entities to non-profit and for-profit organizations, to develop a robust rehabilitation program. Mayor Duggan has made a good start here with his zero interest loan program, but many families cannot meet the income and other requirements required by this program. We need grant programs to assist these low income homeowners.
  • Many thousands of families are living in homes that have black mold and other major damage from the August, 2014 floods across Detroit and other communities in Southeast Michigan. FEMA and other agencies need to invest in these homes to protect people from major health problems.

Healthy Homes Risk Assessments 

These maps below are based on a random sample of 500 homes spread broadly across Detroit. At each house assessors completed a Healthy Homes Rating System assessment that examined 29 potential hazards. This rating system is a HUD-endorsed rating instrument that assesses both the probability of injury and extent of injury from a hazard.  Three of the most frequently occurring and severe hazards were excess cold, mold and dampness and lead paint. The following three maps portray of the areas of Detroit that had the highest levels of hazards.

Lead

HHRSMold Cold

 

[1] This data is collected using the Healthy Homes Rating System (http://portal.hud.gov/hudportal/HUD?src=/program_offices/healthy_homes/hhrs). According to this system, a “high-risk” hazard is identified by a rating of A, B or C on a scale of A-J, A being highest likelihood of serious injury or death and J being minimal risk.

[2] This calculation is based on the April 1, 2010 estimate based on the Census and a 2014 estimate from SEMCOG, broken down into a monthly estimate by simple division across the months.

[3] SEMCOG Community Profile, City of Detroit (http://www.semcog.org/Data/Apps/comprof/people.cfm?cpid=5)

[4] At best only several hundred houses a year are being improved to systematically reduce health hazards. It is important to note, however, that about 806 new housing units were constructed in Detroit last year.

[5]U.S. Census Bureau, Demographic and Housing Estimates, 2013 American Community Survey 1-Year Estimates, Detroit city, Michigan (http://factfinder2.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_11_5YR_DP04)

[6] U.S. Census Bureau, Households and Families, 2013 American Community Survey 1-Year Estimates, Detroit city, Michigan (http://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_13_1YR_S1101&prodType=table), U.S. Census Bureau, Households and Families, 2013 American Community Survey 1-Year Estimates, Detroit city, Michigan (http://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_13_1YR_DP04&prodType=table) This is probably an underestimate as we were unable to obtain of precise occupancy data for post-1980 housing.

[7] It is also important to know that lead paint was banned for use in residences in 1978 and taken off the shelves in 1980.

[8] This estimate is based on the results from the Healthy Homes Rating System being conducted in Detroit.

[9] This cost may include the replacement of all windows within the home as this is a major source of lead.

Seven percent of Detroit’s Liquor License holders located less than a half mile from an elementary school

In 2012, there were about 1,130 establishments in the city of Detroit with liquor licenses, of which nearly 7 percent were located within 0.1 mile of an early learning center or elementary school. In viewing the maps below, we see that the highest concentration of liquor license holders was within the Central Business District, with a medium density of the license holders spanning out into the lower Woodward Avenue, Corktown, and Lower East Central areas.

In Michigan there are several types of liquor licenses which can be obtained. These include licenses needed to sell just beer, those need to sell beer and liquor at a golf course, a hotel, a bar and at a private event. Additionally, brewpubs, distilleries, wholesalers (both those in state and those out of state bringing goods in), winemakers, and stores selling beer and/or liquor need a license. All liquor licenses in the state of Michigan are issued by the Michigan Liquor Control Commission.

According to a study by the Pacific Institute, a high concentration of liquor stores holders can may be related to several public safety and health problems, ranging from high rates of alcohol related hospitalizations, to pedestrian injuries, to high levels of crime and violence. According to data from the Federal Bureau of Investigation we know that Detroit’s crime rate was 2,122.9 per 100,000 residents in 2012, while the state of Michigan’s was 454.4 per 100,000 residents.

The above density map shows where the liquor licenses in Detroit are located and how some areas have a higher concentration of such licenses. As already stated, the highest concentration was in the Central Business District, where there is a combination of bars, restaurants, and liquor stores.

In the map below, we see where liquor license holders were located, along with what the poverty rates. The majority of the liquor license holders ( 683 or 60 percent) were located in census tracts where the poverty rates ranged between 25.1 and 50 percent. Although the Central Business District had the highest concentration of liquor license holders, the poverty rate in these census tracts was 25 percent or lower. Throughout the entire city there were 205 liquor license holders in census tracts where the poverty level was 25 percent or less.

Of the 1,129 liquor license holders in the city of Detroit, 79, or 7 percent, were located within 0.1 mile of an elementary school or early learning center.

According to the Pacific Institute study, a high concentration of liquor stores (in this post we look at liquor license holders) can lead to several public safety concerns, particularly crime.

In addition to crime being mentioned in the Pacific Institute study, it also discussed how the location of schools near liquor stores can affect the overall health and well-being of the community and the children within those communities. Although there are likely many suggestions on how to better a communities wellbeing, some solutions for Detroit officials may include: enforcing zoning ordinances to restrict nuisance activity by liquor stores or establishments that hold a license, using economic development strategies to transition current liquor stores into places for residents to access healthy foods, and working with the state to re-determine how many liquor licenses the city of Detroit should actually hold and/or what policies should be in place preventing the location of liquor license holders within a certain proximity to schools.