Lower Life Expectancy Related to Lack of Health Insurance

The correlation between life expectancy and those who are uninsured is -0.617 (sig. 0.00), meaning that there is moderately strong tendency for the length of life to decline as lack of access to health care (i.e. being uninsured) increases. In general, those without health insurance tend to live shorter lives. For example, in the City of Detroit, there are more than 25 different Census Tracts where residents have a life expectancy of 70 years of age or less. Of those Census Tracts, majority of them have 21 percent of the population or more living without health insurance. Even as life expectancy increases to the median range of the spectrum in Detroit, the evidence shows that majority of the Census Tracts have about 13 percent of the population or more without health insurance. Interestingly though, only one of the four Census Tracts where the average life expectancy is 65 years of age has 21 percent or more of the population living without health insurance. The other three Census Tracts with such an average life expectancy has between 13 and 21 percent of the population living without health insurance.

When moving beyond the boundaries of Detroit, in many of the outer-ring suburbs life expectancy increases as does the percentage of residents with health care. For example, majority of Washtenaw, St. Clair and Monroe counties have less than 13 percent of the populations living without health insurance and average life expectancies at 76 years of age or higher. With the exception of one Census Tract in southern Monroe County, no other areas in those three outlying counties have more than 21 percent of the population living without health insurance. As you do move in closer to Detroit though, there are wider ranges of life expectancies and access to health care. In Wayne County, for example, areas such as Romulus and Lincoln Park also have lower life expectancies (70 years of age or less) and more than 21 percent of the population not having health insurance. But, there are also areas, such as Grosse Ile, where the average life expectancy is 86 years of age and above and 8 percent or less of the population do not have health insurance. While the average life expectancy tends to be higher in Macomb and Oakland counties, there are still pockets, such as South Warren, Mt. Clemens and Pontiac, where the average life expectancy is 70 years of age or less and those without health insurance is at about 13 percent or higher.

As has been shown through some of the examples above, there is a moderately strong negative correlation between the percentage of the population living without health insurance and the average life expectancy of Census Tracts in Southeastern Michigan. This is further demonstrated in the chart above, which ultimately shows that as the percentage of the population living without health insurance increases the average life expectancy decreases. The chart also shows though that majority of the Census Tracts in Southeastern Michigan have an average life expectancy of about 75 years of age or higher with 10 percent of less of the population living without health insurance.

 

Overall, these maps and the graph show that while there is a range in life expectancies in Southeastern Michigan, there is also a range in those with access to health care, particularly those in and around Detroit. Access to health care is important as health care providers can not only treat, but also prevent, a plethora of illnesses and diseases. Such knowledge and treatment is vital for longer life expectancies.

Poverty Affects Life Expectancy in Detroit, Region

There is a huge variation in life expectancies in Southeastern Michigan, from an average of 62 years in the lowest Census Tract to a high in 85.9 in the highest tract. Moreover life expectancy is closely and negatively related to poverty. The correlation between life expectancy and poverty is -0.713 (sig. 0.01), meaning that there is moderately strong tendency for the length of life to decline as poverty increases in a tract. Or, put simply, poor people die sooner, a lot sooner. Both the maps and chart below present the relationship between shorter life expectancy and poverty or conversely lower levels of poverty in a tract and higher average life expectancy. At the same time, the majority of the areas in Southeastern Michigan have 20 percent or fewer of families living below the poverty line, along with average life expectancies between about 75 and 85 years of age. For reference, the average life expectancy in the United States is about 79 years of age and the federal poverty level for a family of four is $24,300. In 2017 12.7 percent of the U.S. population was living in poverty.

For the City of Detroit there is an average life expectancy across tracts is 71 to 75 years of age, although there are several Census Tracts where the average life expectancy is well below 70. Most of the Census Tracts in Detroit, especially those with lower life expectancies, have more than 28 percent of the population living at or below the poverty line. Specifically, there are three Census Tracts in Detroit where the average life expectancy is between 62 and 65 and the percentage of the population living below the poverty line ranges from about 29-100 percent (the highest threshold in the Detroit map below). While Detroit demonstrates the correlation between higher than average poverty rates and lower life expectancy, there are certain parts of the region where the life expectancy is about on par with the national average (78.8 years of age) but the percentage of the population live in poverty is at or below the national poverty rate (12.7 percent). These examples occur in the mainly the rural areas of the region, such as parts of St. Clair, Livingston and Monroe counties. In general though, radiating out beyond Detroit and the inner-ring suburbs, poverty levels decrease, and the average life expectancy increases. For example, in nearly all of western Washtenaw County the average life expectancy ranges from 81-85 with the poverty levels being at or below 12 percent.

As has been attributed in some of the specific examples noted above, there is a moderately high negative correlation between the percentage of the population living at or below the poverty line and the average life expectancy of Census Tracts in Southeastern Michigan. When looking at the median poverty levels of the region with the life expectancies there is a -0.713 P value, which is statistically significant at the .01 level. What this means is that as the percent in poverty increases, there is a tendency for average life expectancy to decrease.

Overall, these maps show that throughout Southeastern Michigan there is a wide range in life expectancy and poverty levels, with outer ring suburbs faring better and more urban areas, such as Detroit, and some rural areas faring worse. While we see here that poverty does relate to average life expectancy rates, other factors that may also affect average life expectancy include access to health care and educational attainment. The correlation between these factors and the average life expectancy will be explored in the next two posts.

Turkeys, Chickens and Ducks

As Thanksgiving approaches it is worth noting that our state has had a great success in expanding wild turkey populations across the state from near extinction in 1900 to over 200,000 birds across the state nowadays. All but the most densely populated areas of Southeastern Michigan have wild turkeys. And now they will find many cities are allowing their domesticated cousins—chickens. And at least one has added ducks.

Across Southeastern Michigan there are 30 communities that allow for residents to house chickens on their property, according to recent research conducted by the Detroit Free Press. These communities have various ways of allowing residents to have the chickens on their property. For example, in the City of Warren residents are allowed to have three hens and pay a $10 registration fee to have the chickens. In the City of Berkley though restrictions are bit tighter, with only five permits available for residents to have backyard chickens.

It is within the purview of each community as to whether or not they want to allow backyard chickens and to what extent they will be allowed. This local control comes from a rule the Michigan Agriculture Commission adopted in 2014 that essentially states not everyone can claim rights under the Right to Farm Act. The rule is intended to protect the overall goal of the Right to Farm Act, which is to protect industrial sized farmers in rural communities. The local control aspect of backyard livestock and poultry allows more suburban and urban communities to decide what is best for their community and residents. As noted above some communities only allow a certain number of permits to be distributed, while others require a fee to be paid, and only a certain number of hens to be owned by an individual. While there are 30 communities in Southeastern Michigan that allow residents to own chickens, there are 21 that have banned them. Ann Arbor recently added ducks to the list of animals backyard farmers can cultivate.

Reasons individuals want to house chickens in their backyard typically links back to wanting the chicken’s eggs. Hens can lay up to five eggs per week. Reasons communities cite for wanting to ban them include the allegation that the chickens, and their feed, may attract rats and that the hens themselves may be a noise nuisance.

Elderly Population Continues to Grow in Southeastern Michigan

While there are only 10 communities in Southeastern Michigan with more than 21 percent of the population 65 years of age or older, the number of communities with a growing elderly population is far greater than those with a declining elderly population. According to the data, majority of the rural communities throughout Southeastern Michigan-Monroe, Washtenaw, Livingston, St. Clair and northern Macomb and Oakland counties-have seen the greatest increases in a growing elderly population. Overall, St. Clair County’s elderly population grew the most between 2010 and 2016, with nine of the communities experiencing between 6 and 13 percent increases in the 65 years of age and older population. In St. Clair County, Algonac (21%), China Township (22%) and East China Township (26%) had the highest percentage of elderly residents in 2016. However, it was Lake Angelus, in northern Oakland County, that had the highest percentage of resident 65 years of age or older at 35 percent.

Detroit, and its inner and outer ring suburbs have the highest concentration of the aging population that is growing at a slower rate. As the second map below shows, majority of the Detroit suburbs did not experience a growth of the 65 years of age and older population above 2.5 percent between 2010 and 2016. In fact, some of those communities (Hamtramck, Grosse Pointe, Redford, Dearborn Heights) experienced an overall decline in the 65 years of age and older population between 2010 and 2016. In Detroit, the 65 years of age and older population only grew by 1.6 percent between 2010 and 2016. According to the data, in 2010 the elderly population was at 11 percent and by 2016 it grew to 12.6 percent. In Hamtramck, the 65 years of age population decreased from 9.1 percent in 2010 to 7.8 percent in 2016.

According to a recent Detroit Free Press article, by 2025 the number of people above the age of 65 will outnumber those 17 and younger. Nationally, such a growth of the elderly population isn’t expected to occur until 2035. There are varying reasons for the growth of the 65 years of age and older population locally, and nationally, including better medical advancements allowing people to live longer and the decline in birth rates over the year. One reason for what appears to be the quicker growth of the aging population in Michigan though is the fact that over about the last decade, particularly during the Great Recession, people have left to find jobs elsewhere. So, in short, out-migration has contributed to the fact that Michigan’s elderly population will outnumber its younger population within the next decade.

Public Transportation for Work Commute Underutilized in Southeastern Michigan

Throughout Southeastern Michigan public transportation to get to work is utilized by less than 2 percent of the population in almost every community, according to 2016 Census data. The only community in Southeastern Michigan where more than 11 percent the population utilizes public transportation to travel to work is Highland Park. According to the data, 17.5 percent of the Highland Park population utilized public transportation to travel to work in 2016. It should be noted that Highland Park also has the lowest median income and highest poverty levels in Southeastern Michigan. Additionally, Highland Park has both Detroit Department of Transportation (DDOT) and the Suburban Mobility Authority for Regional Transportation (SMART) stops in the city. Next to Highland Park, Detroit, Ann Arbor and Ypsilanti have the next highest public transportation usage rates for commuting to work, ranging from 5 to 11 percent. These areas also have access to dedicated public transportation systems. For example, in Detroit there is DDOT, which also collaborates with SMART, and in Ann Arbor there is the Ann Arbor Area Transportation Authority.

While there are dedicated public transportation systems throughout Southeastern Michigan, they do not service all of the region. This fact is particularly showcased in the map above; nearly all of the green communities have no or limited access to public transportation. In some areas, like throughout much of Monroe, St. Clair, Livingston and Washtenaw counties, there are no sources of public transportation even offered to community members. While in Wayne, Oakland and Macomb counties access to public transportation is offered, but communities must vote on whether or not to support and utilize the services, such as with the SMART votes (how this service works is detailed here).

Understanding the region’s transit system, or lack there of, is important when reading about the usage of public transportation. When viewing just the numbers it could easily be argued a regional transit system isn’t needed because of the low percentage of users. However, further knowledge on public transportation in Southeastern Michigan shows that there is actually a lack of access, connectivity and education on the economic and community benefits related to public transportation.

Metro-Detroit Transit Continues With Uphill Battle Despite SMART Millage Passage

The Suburban Mobility Authority For Regional Transportation (SMART) received a vote of confidence from the tri-county region for its four-year 1 mill millage renewal, which was also a slight increase for communities in Macomb and Oakland counties (the increase request was due to Headlee amendment rollbacks in previous years that brought original 1 mill rate slightly below that). However, even though election results show the SMART millage passed in Macomb County and in areas of Oakland and Wayne counties on Aug. 7, 2018, there were questions if that was really the case. In mid-August the Michigan Taxpayers Alliance requested a partial recount of the Macomb County SMART millage vote because the millage proposal only passed by 39 votes. According to the election results, 77,500 Macomb County voters were in favor of the millage renewal and increase and 77,461 Macomb County voters cast a ballot against the proposal. With a 50 percent passage rate, the group felt a recount was needed to ensure the results were accurate. On Aug. 29 the group stopped the partial recount because it became evident that there would not be enough “no” votes to overturn the originally approved millage approval, according to a Michigan Radio news article.

In Wayne County the SMART millage had a 73 percent passage rate, with 78,943 of the voters in favor of the millage renewal and slight increase. Oakland County had the highest pass rate at 77 percent, with 123,435 of the voters in favor of the proposal and 36,723 of the voters voting against it.

SMART, which is the region’s only existing transportation system outside of the Detroit Department of Transportation’ system, was created in 1967. As is evident by the maps above, the system operates throughout the tri-county region, but not necessarily in every community. Due to the way SMART initiatives can be placed on the county ballots (by individual counties), Macomb County is the only county in which the entire county (50 percent or more) must support a SMART millage in order for it to approved. This is why such a close approval rate for the Aug. 7 millage, and the potential of a recall, were vital for Macomb County, it’s either all or nothing. Unlike Macomb County, Oakland and Wayne counties communities have the option to “opt-out” of supporting the authority. In the second map above, data on approval rates for all Macomb County communities is available, and only partial information is available for Oakland County communities. For the Oakland County communities, these are the “opt-in” communities that approved the SMART proposal.

 

No data was available for the Wayne County communities through the Wayne County Election’s Office website; the only information available was the pass/fail rate for the millage proposal for the whole county.

In Macomb County, the cities of Grosse Pointe Shores and Eastpointe had the highest passage rates at 61 percent. Ray Township had the lowest approval rate at 31 percent, according to the results. As noted, all the Oakland County communities on the second map above had approval rates above 50 percent, because they “opted in” to use the SMART service. Of those communities, Huntington Woods had the highest approval rate at 90 percent and Walled Lake had the lowest at 70 percent.

While SMART continues to be the only regional transit authority in Southeastern Michigan, this recent election confirms again that the region has a lot of room to grow in providing equal and equitable transportation services throughout the region. If Macomb County voters did not pass the millage request, public transportation in the county would likely have ceased to exist. And, in many parts throughout Oakland and Wayne counties transportation gaps are huge.

 

More Underfunded Retiree Healthcare Plans than Pension Plans in Southeastern Michigan

In Southeastern Michigan more government entities were found to have underfunded retiree healthcare plans than the number of government entities with underfunded pension plans. According to the data provided by the Michigan Department of Treasury there were 50 underfunded retiree healthcare systems of the 183 government entities that had provided their financial information to the State as of June 9, 2018. A government entity’s retiree healthcare plan is deemed underfunded by the State if it is less than 40 percent funded and has an annual contribution greater than 12 percent of government funds.

Of the municipalities that were deemed funded by the State, Rose Township had the highest funding percentage for municipalities at 331 percent. Other municipalities with retiree healthcare funding above 100 percent are:

Municipalities

  • Rose Township: 331%
  • Groveland Township: 197%
  • Algonac: 163%
  • Oakland County: 127%
  • Detroit: 121%
  • Macomb Township: 114%
  • Royal Oak: 107%
  • Pontiac (Police and Fire): 105%
  • Milford: 104%
  • Farmington Hills: 100%

Special Districts

  • West Bloomfield Public Township Public Library: 147%
  • Brighton Area Fire Authority: 109%

While there was about a dozen different Southeastern Michigan government entities with more than 100 percent of the retiree healthcare plans funded, there were also 37 entities that had 0 percent of the retiree healthcare plan funded. However, not all of these entities were deemed underfunded, rather only 18 were. Not all government entities that fell below the 40 percent threshold were deemed underfunded due to the fact they were contributing less than 12 percent of their revenue to fund the plan. For example, the City of Brighton has 11 percent of its retiree healthcare funded, but according to the Michigan Department of Treasury, the city’s annual contribution to the plan is 10.4 percent of the City’s revenue. This is less than the 12 percent trigger point set by the State.

As with pension systems, funding retiree healthcare systems is vital not only to a government entity’s financial healthy, but also to retention and recruitment of employees.

 

Southeastern Michigan Communities Working to Fund Pension Systems

In 2017 the Protecting Local Government Retirement and Benefits Act was passed, with the goal of identifying the systems that are underfunded. According to the State of Michigan, a retirement fund is underfunded if less than 60 percent of the fund is funded, and there is an annual required contribution that is over 10 percent of governmental fund revenues. While 60 percent is the current threshold, there are discussions that eventually that number will continue to increase to 100 percent to more accurately reflect the funded status of a retirement plan. There are also thresholds that determine if a local government entity has an underfunded retiree health care system, an issue we will explore next week.

Currently, in the State of Michigan local government entities are facing, in total, over $18 billion in unfunded liabilities for retirement and retiree healthcare funds, according to the Reason Foundation. This foundation worked with the State of Michigan to develop the Protecting Local Government Retirement and Benefits Act and the reporting system that goes along with it.

The maps below provide details on what local government retirement plans are preliminary funded or underfunded in Southeastern Michigan, as determined by the Michigan Department of Treasury through implementation of the Protecting Local Government Retirement and Benefits Act. These are deemed preliminary due to the fact the new oversight body for determining funded, unfunded and waiver status must still review information submitted. Note, information is not displayed for all local government units in the region because not all units had provided their funding as of June 9, 2018. Additionally, some local government units beyond cities and townships are included in the data provided by the State, such as public safety retirement funds.

Of the 183 local government entities (this includes multiple funds for one municipality) that submitted their retirement funding information to the State for the Southeastern Michigan region, 37 of them were reported as having an underfunded status, or less than 60 percent of the retirement fund being funded. Of those that were reported as being underfunded, the majority of them had 45 percent or more the entity’s retirement system funded. However, there were five entities with 25 percent or less of the retirement system funded. These entities were:

  • Capac (St. Clair County): 24.2%
  • Highland Park General Employee fund: 2%
  • Highland Park Public Safety Fund: 3.7%
  • Highland Park Police and Fire Fund: 6.8%
  • Taylor City Housing Commission Authority: 0%

It should be noted that while the City of Taylor’s Housing Commission Authority retirement fund is underfunded, the City of Taylor’s general employee and police and fire retirement funds met State guidelines to be determined funded.

As part of the newly adopted State legislation related to retirement and retiree health care plans a Municipal Stability Board was created to review the corrective plans that underfunded entities must create and submit to the State. This board is housed under the Michigan Department of Treasury is made up of three individuals appointed by the governor. Corrective plans must be developed and submitted within 180 days of the State determining an entity’s retirement system is underfunded.

 

On the opposite side of the spectrum, while there were far more local government entities that were determined have funded retirement systems, than not, there were several that were more than 100 percent funded. The entities with the highest percentage of funding for their retirement funds were:

  • City of Ferndale (General Employees): 253%
  • City of Dearborn (Chapter 24): 239%
  • City of Pontiac (General Employees); 176%
  • City of Ypsilanti (General Employees) 126%
  • City of Grosse Pointe: 119%
  • City of Troy: 117%
  • Lima Township: 112%
  • City of Grosse Pointe Farms: 111%
  • City of Gibraltar (General Employees): 106%
  • City of Dearborn (General Employees): 104.3%
  • City of Mt. Clemens: 103%
  • Oakland County: 103%
  • City of Gibraltar (Public Safety): 102%
  • Groveland Township: 101%

Funding of retirement plans is vital for all local government entities as underfunded plans can lead to long-term financial troubles for a government entity, not excluding bankruptcy. Additionally, underfunded plans can also affect recruitment and retention of employees.

How Detroit is Tackling Rental Code Enforcement, Lead Remediation

The City of Detroit recognizes that lead poisoning prevention is multi-faceted, which is why an Interagency Lead Poisoning Prevention Task Force was created earlier this year, the same time the codes rental properties in the City were tightened. The task force will eventually align future rental code enforcement target ZIP codes with the zip codes where there is a high prevalence of elevated blood lead levels in children. Currently though, the rental code compliance program overseen by the Buildings, Safety, Engineering and Environmental Department (BSEED) is focusing zip codes that do not have among the highest percentage of children 6 years of age and younger with lead poisoning.

The zip codes BSEED is currently enforcing compliance on are: 48215, 48224, 48223, 48219, 48209 and 48210. These six zip codes are the first priorities of the City’s new, stricter rental code ordinance that seeks to ensure all rental properties are properly registered, up to code and have obtained a certificate of compliance. One aspect of the new ordinance is that all rental properties, despite the length of their certificate of occupation, must have annual lead hazard inspections. According to the ordinance, the annual assessment can be waived only if the property owner has taken more long term or permanent measures to abate the lead.

 

While this ordinance does make lead assessments and abatements a priority for all rental properties, the zip codes identified to have among the highest percentage of children 6 years of age and younger are not included on the initial and current compliance schedule, which is available here (link to BSEED). According to the City of Detroit, the 48210 zip code is to be launched into the new compliance program on Aug. 1, 2018 and is scheduled to have all rental properties in compliance with the new ordinance by Feb 1, 2019. This is certainly a step in the right direction, however, the zip codes with among highest percentage of children with lead poisoning have yet to be placed on the compliance list. The City of Detroit does state though that all rental properties in the City must be in compliance with the new ordinance by the end of 2020.

 

The zip codes where recent data shows there is the highest prevalence of elevated blood lead levels in Detroit’s children are: 48202, 48204, 48206, 48213 and 48214. According to the City of Detroit Health Department, these zip codes will be included in the new rental property compliance program, but all also be part of the Lead Poisoning Prevention Pilot Program, which is being spearheaded by the Interagency Lead Poisoning Prevention Task Force. As part of this pilot program, there will be door-to-door outreach in the identified zip codes. This outreach will provide occupants, particularly those with children or who are pregnant, with information on how to identify potential lead hazards and protect themselves from the risks. Lead testing will also be provided through this program.

As the information above shows, the City of Detroit has taken steps through both rental code enforcement and direct outreach facilitated through the Health Department. However, direct coordination between the initial enforcement phase of the new rental property compliance ordinance and the Interagency Lead Poisoning Prevention Task Force has yet to fully materialize. The map below highlights just this. The zip codes in red are the ones the City has identified as having the prevalence of elevated blood lead levels in children. The zip codes in blue are the ones that have been identified for the most immediate rounds of registration and compliance for the new rental code.

The information provided in the map below is from the City of Detroit’s website.

Evictions Highest in Detroit, Inner-Suburbs

In 2016, the City of Harper Woods just northeast of Detroit, had the highest eviction rate in Southeastern Michigan, according to Eviction Lab. Eviction Lab is a nationwide data base created by Princeton University that shows formal evictions that have taken place throughout the country; these formal evictions are ones that occurred through the court system. In Harper Woods, the eviction rate was 9.9 percent per 100 rental units; this was equivalent to 175 formal evictions in 2016. The City of Dearborn Heights, which is just west of the City of Detroit, had an eviction rate of 9.82 percent per 100 rental units, which was equivalent to 502 total evictions.

The Top 5 Eviction Rates (per 100 rental units) in Southeastern Michigan by City were:

  • Harper Woods: 9.9
  • Dearborn Heights: 9.82
  • Bellevue 9.44
  • Ecorse: 9.29
  • Inkster: 8.18

No data was available for the townships in the above map with the very light green.

While inner-ring suburbs ranked the highest for eviction rates in Southeastern Michigan, the City of Detroit had the most evictions in terms of sheer volume. In total, there were 6,664 formal evictions in the City of Detroit in 2016; this was equivalent to an eviction rate of 5.2 percent per 100 rental units.

When examining eviction rates at a Census Tract level in Detroit, the data shows that there were only four Census Tracts with eviction rates above 11 percent. Two of these Census Tracts were located on the City’s west side and the other two were located on the far east side of the City. The majority of the central part of Detroit, and into Southwest Detroit, did not have formal eviction rates above 5.3 percent in 2016, according to the data. The west of the City had the highest concentration of formal eviction rates above 7.7 percent.

Understanding eviction rates for the City of Detroit, and the region, is important because this data further demonstrates how income inequality affects the citizens of Southeastern Michigan. Evictions occur when a rental tenant is involuntary removed from his or her home. Evictions can occur due to the tenant’s inability to pay rent, along with reasons such as property damage and taking on boarders. Clearly though, there is a relationship between income and evictions. For low-income families, a single monetary emergency can mean a missed rent payment, and ultimately eviction. As can be seen in the first map, many of the cities in Southeastern Michigan with a 0 percent eviction rate are those with higher than average median incomes, such as Bloomfield Hills and Birmingham. Detroit, Ecorse and Inkster are among the cities in Southeastern Michigan that do not have such socioeconomic characteristics. Rather, Detroit, Ecorse and Inkster have among the lowest median incomes in the region and some of the highest eviction and poverty rates.

This discussion on eviction rates will certainly be part of our overall poverty review of Southeastern Michigan, which will also examine median incomes, poverty rates, homeowner status and education levels.

To understand the dynamics and consequences of eviction for the poor, see: Evicted: Poverty and Profit in the American City by Matthew Desmond.