Monthly Archives: December 2021

Race Impacts Maternal Mortality, Vulnerability in Michigan and Beyond

by Drawing Detroit | Leave a comment

Most recently we explored the Maternal Vulnerability Index (MVI), as created and explained by Surgo Ventures, for Michigan and the seven county Southeastern Michigan region. The six sub-indexes that make up the MVI (Reproductive Healthcare, Physical Health, Mental Health and Substance Abuse, General Healthcare, Socioeconomic Detriments and Physical Environment) are based around factors that include access to healthcare, criminal activity in an area and physical and mental health. The direct data around these factors, and more, directly impact a mother’s health. But, another contributing factor to a mother’s health, both directly and indirectly, is her race. According to the MVI by Surgo Ventures, the Midwest has an MVI average score of 37 out of 100, and the highest vulnerability gap between black women and the regional average. Black women are exposed to a 9 point higher vulnerability score than the regional average, driven by higher exposure to vulnerability based on the following sub-indexes: physical health, mental health and substance abuse, socioeconomic determinants and physical environment.

While the MVI does not examine the vulnerability scores at the county and state level through a racial lens we do know the following.

The percentage of the black population in Michigan is 14 percent and the percentage of the black population in Southeastern Michigan is:

  • Livingston County: 0.5%
  • Macomb County: 12%
  • Monroe County: 2%
  • Oakland County: 14%
  • St. Clair County: 3%
  • Washtenaw County: 12%
  • Wayne County: 39%

The percent of black women between the ages 15-50 who gave birth in the past 12 months (2019) was:

  • Livingston County: NA
  • Macomb County: 3%
  • Monroe County: 5
  • Oakland County: 4%
  • St. Clair County: NA
  • Washtenaw County: 5%
  • Wayne County: 6%

Percent of white women between the ages 15-50 who gave birth in the past 12 months (2019)

  • Livingston County: 6%
  • Macomb County: 5%
  • Monroe County: 5%
  • Oakland County: 5%
  • St. Clair County: 6%
  • Washtenaw County: 4%
  • Wayne County: 5%

Percent of black women at or below the poverty level between the ages of 18-64 (2019)

  • Livingston County: NA
  • Macomb County: 5%
  • Monroe County: NA
  • Oakland County: 6%
  • St. Clair County: 13%
  • Washtenaw County: 7%
  • Wayne County: 9%

Percent of white women at or below the poverty level between the ages of 18-64 (2019)

  • Livingston County: 1%
  • Macomb County: 3%
  • Monroe County: 4%
  • Oakland County: 2%
  • St. Clair County: 3%
  • Washtenaw County: 4%
  • Wayne County: 4%


Furthermore, of the black residents in Southeastern Michigan between the ages of 19 to 64 years of age the following percentage had no health insurance in 2019:

  • Livingston County: 4%
  • Macomb County: 5%
  • Monroe County: 5%
  • Oakland County: 4%
  • St. Clair County: 4%
  • Washtenaw County: 5%
  • Wayne County: 6%

Of the white residents in Southeastern Michigan between the ages of 19 to 64 years of age the following percentage had no health insurance in 2019:

  • Livingston County: 3%
  • Macomb County: 5%
  • Monroe County: 3%
  • Oakland County: 4%
  • St. Clair County: 4%
  • Washtenaw County: 3%
  • Wayne County: 5%

While the numbers don’t very greatly, it does show that while there are fewer black women in Southeastern Michigan there is at least an equal, and in some cases a greater, percentage of them who live in poverty, have had children and who do not have health care. Of course, the MVI also looks at factors such as crime where women live (Wayne County has the highest percentage of black residents in the region and the state and Detroit also has one of the highest crime rates), their access to mental health and addiction services, obesity and diabetes rates. All of these are also factors as to why black women in the Midwest are exposed to a 9 point higher vulnerability score than the regional average, which is 37.

Physical Health May Be one of the Biggest Impediments for Maternal Health in Southeastern Michigan

by Drawing Detroit | Leave a comment

The Michigan maternal mortality rate was 16.4 per 100,000 live births in 2018, according to the National Center for Health Statistics. At the national level in 2017 the maternal mortality rate was 17.4 per 100,000 live births. While Michigan’s numbers were slightly less than the national average, they are still concerning, especially considering the United States has among the highest maternal mortality rates across amongst other nations.

Maternal deaths include deaths of women while pregnant or within 42 days of termination of pregnancy irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes.

Understanding, and improving, maternal mortality is important because it helps highlight the effectiveness of the country’s health care system as it relates to general, obstetric and infant care, and is also a human rights issue, as everyone deserves quality and equal care.

In the graphs below we show what factors impact maternal mortality rates and maternal health in general. Several factors, based off maternal health and community data, were combined by Surgo Ventures, a privately funded action tank, to create the Maternal Vulnerability Index (MVI). This index represents six categories, or sub-indexes, in total: Reproductive Healthcare, Physical Health, Mental Health and Substance Abuse, General Healthcare, Socioeconomic Detriments and Physical Environment. In Southeastern Michigan, and throughout the country, each county and states ranks differently in each category, with the higher number meaning there is an increased vulnerability. This report does not have a national index for the sub-indexes or the MVI as a whole for comparison. The highest level for comparison is at the state level.

The Reproductive Healthcare factor in the MVI is based off a woman’s access to family planning and reproductive services, as well as availability of skilled attendants. As with all the data discussed in this post, the vulnerability level varies greatly by location (again, higher numbers refer to higher vulnerability). In Southeastern Michigan, St. Clair County has the highest Reproductive Healthcare MVI Sub-Index at 50, while nationally there are counties in the Dakotas, Texas, Arkansas, Missouri,  Nebraska and several other states where the Reproductive Healthcare Sub-Index is above 85. The State of Michigan has a Reproductive Healthcare Sub-Index factor of 68. Texas has the highest Reproductive Healthcare Sub-Index of 100 of all 50 states.

For the Physical Health index there is a much wider range of vulnerability in Southeastern Michigan, with Livingston County having a vulnerability level of 0 while Wayne County has a vulnerability level of 88. The State of Michigan has a Physical Health Sub-Index of 66 and comparatively Texas has the highest at 100. The factors that play into the Physical Health vulnerability status include prevalence of noncommunicable diseases and sexually transmitted disease and the percent of females with hypertension, obesity and diabetes. All of these factor can increase the risk of complications and/or death during and after pregnancy.

The Mental Health and Substance Abuse Sub-Index is among one of the higher ones for counties in Michigan, with five of the seven in Southeastern Michigan having a vulnerability index above 50. Macomb County has the highest vulnerability index in the region at 77, followed by Wayne County with an index of 76 and St. Clair County with an index of 74. Michigan has a Mental Health and Substance Abuse Sub-Index of 62 and the State with the highest sub-index is West Virginia at 100. The indicators that play into this index include stress, access to mental health and substance abuse institutions and the overall mental health of mothers in the area.

General Healthcare Sub-Index measures the accessibility, affordability and utilization of healthcare, including insurance coverage and the state’s Medicaid expansion status. Some of the factors of this vulnerability measurement include access to quality medical care, the percent of women of reproductive age who are uninsured, and the postpartum extension status.

St. Clair County has the highest vulnerability index at 45 while Washtenaw County has an index of 0, meaning there is ease in access to and affordability of healthcare for reproductive age women. Michigan has a General Healthcare Sub-Index of 29, and comparatively, the two states with the highest sub-index are Mississippi and Alabama at 100.
General Healthcare Sub-Index measures the accessibility, affordability and utilization of healthcare, including insurance coverage and the state’s Medicaid expansion status. Some of the factors of this vulnerability measurement include access to quality medical care, the percent of women of reproductive age who are uninsured, and the postpartum extension status.
St. Clair County has the highest vulnerability index at 45 while Washtenaw County has an index of 0, meaning there is ease in access to and affordability of healthcare for reproductive age women. Michigan has a General Healthcare Sub-Index of 29, and comparatively, the two states with the highest sub-index are Mississippi and Alabama at 100.
The final sub-index in the overall MVI is Physical Health, of which Wayne County has the highest rate at 95, both in Southeastern Michigan and in the State of Michigan. Michigan has a Physical Health Sub-Index of 82 and of all 50 states Alabama has the highest sub-index at 98. Environmental factors that influence maternal health outcomes include violent crime rates, housing conditions, pollution and access to transportation.

Overall, Wayne County has the highest MVI in Southeastern Michigan, and the State, at 77. Regionally, the county with the second highest MVI is St. Clair County with a rate of 55. At the state level, Michigan’s MVI is 66 and Alabama has the highest MVI of 100. While we know several factors play into the health of a mother and child, this index allows us to examine how all these factors are connected and provide more definitive answers as to why the US’s maternal mortality rate is so poor.

In examining the factors above, it should go without saying that race, socioeconomic status and location are all overarching factors into the MVI. This is examined on a deeper level through the index though and will be further discussed in an upcoming post.

Metro Detroit Small Businesses Recovering, Need Additional Assistance

by Drawing Detroit | Leave a comment

In 2020, $19.8 billion was spent at small businesses nationwide on Small Business Saturday, a $2 million increase from the $19.6 billion spent the year prior, according to data released by American Express. The hope is that number will be higher in 2021 as many small and local businesses continue to feel economic effects from the COVID-19 pandemic.

According to the Small Business Administration, $0.68 of every dollar spent at a local business remains in the local economy, or $68 for $100 remains in the local economy. Such investment in a local economy is vital for local success, especially currently as, according to the Nov. 15, 2021 US Census Bureau’s Small Business Pulse Survey, 24 percent of Metro Detroit’s small businesses have experienced a large decline in their business because of COVID; 48 percent have had a moderate negative effect; 18 percent have had little or effect on business because of COVID. As the chart shows, more than 70 percent of small businesses in Metro Detroit experienced a large negative effect from the COVID pandemic when it first began. That number has remained below 31 percent since June of 2021 though while the percentage of small businesses in Metro Detroit experiencing a moderate negative effect due to COVID has remained between 40 and 53 percent since June of 2020. And, while the percentage of small businesses experiencing a moderate negative effect on business has remained fairly consistent for more than a year, it is promising to see the percentage experiencing a large negative effect decreasing while the percentage of those experiencing little to no effect has been increasing.

The fact that more small businesses are experiencing little to no negative impact from COVID can also be seen in the percentage of small businesses in Metro Detroit that closed, according to the Nov. 15 2021 Small Business Pulse Survey. The survey asks respondents if their business either temporarily or permanently closed a location in the previous week. The survey covers almost all private-sector industries, including construction, manufacturing, retail, finance, professional and business services, and leisure and hospitality. According to the Nov. 15 survey, 3.3 percent of small businesses surveyed in Metro Detroit had closed. While that is an increase from the 2.3 percent that closed according to the Oct. 11, 2021 survey, it is a decrease from the 9.2 percent that closed about a year ago.

While data does show optimistic signs for a recovering economy, there are still many areas in which small businesses need assistance in to ensure success.

According to the Oct. 11 2021 Small Business Pulse Survey, the largest need for local small businesses in Metro Detroit is to identify and hire new employees. According to the survey, 49 percent of the local small businesses survey said they need to identify and hire new employees for their future success. In the Nov. 15 survey, 39 percent of small business Metro Detroit respondents said they needed to obtain additional financial assistance or capital for future success, 38 percent said they need to develop online sales or web sites and 27 percent needs to develop more supply chain options.

So, while there are signs of economic recovery of for small businesses there are still many needs for their future, and long-term success. Despite an unemployment rate of 6.1 percent in Michigan, there is still a need for employees. As we have discussed prior, living wages are means to attract employees, along with benefits that support employees’ physical and mental health. Navigating the supply chain is a much more difficult concept, as mega-retailers such as Amazon and Walmart continue to be leaders of the pack because of their buying power. However, this could lead to the argument that, given the opportunity, small businesses should fill their inventory with local goods—that is much easier said than done though. Locally made items are much different than items bought from a local store.

The issues surrounding the local economy can be complex, but we can all do our part and invest in small businesses in the holiday season, and year-round. Supporting local not only gives a local business and a local family a chance to survive, but it also strengthens the identity and success of a community.