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Health and Health Insurance

Overview

There are many datasets reporting on the health of residents in all communities. Exploring these datasets can help to identify opportunities and challenges for communities, governments, organizations and residents whose work may focus on the health of the local residents. Health data covers a vast array of areas including death, immunizations, elevated blood lead levels, hospital visits through Medicaid and several datasets focused on health insurance. These topics can be explored individually or combined to help understand the full picture of the health of residents in a community.

Take Action!

Is this an issue you care about? Connect with one of the organizations below to find resources and support on this topic.

Get the Lead Out Detroit Coalition

The Get the Lead Out Detroit Coalition (Coalition) was established with the support of the Fred A. and Barbara M. Erb Family Foundation with a purpose of reducing the number of Detroit children poisoned by lead hazards in the home and in soil by identifying and executing strategies to support lead safe kids and lead safe homes for families.

Hope Starts Here

The HSH framework is composed of six teams focused on promoting health, youth development and well-being, parent and family leadership, providing high quality programs and professions, creating safe and inspiring environments, better alignment of resources and systems, and increasing and aligning early childhood system funding.

Help Me Grow

Help Me Grow helps families find child development check-ups, parents support, quality early learning, basic needs, healthcare or behavior support, home visiting programs and much more!

All data sources are from the American Community Survey unless otherwise noted.

Indicators on the Profile Page

Why It's Important

Infant Mortality (MDHHS)
  • Number of infant deaths
  • Infant deaths by cause
  • The infant mortality rate is a key measure of the overall health of a community. Beyond being a common benchmark that can be used to measure how health is faring in Detroit compared to other communities, data about specific causes of infant mortality can help to inform education and outreach activities that aim to lower this rate.

Immunizations (MDHHS)
  • Fully immunized children aged 19-35 months
  • Immunized children aged 19-35 months by status
  • Immunization rates are an important means of understanding how very young children in an area are accessing (or are not accessing) medical care. Lower immunization rates indicate that children might not necessarily attend recommended medical appointments, and can also increase the risk of harmful disease outbreaks in a community.

Elevated Blood Lead Levels (EBLL) (MDHHS)
  • Percent of individuals tested with an elevated blood lead level
  • Percent of individuals tested with an elevated blood lead level by age
  • It is extremely important to identify and mediate exposure to lead whenever possible, especially for young children as EBLLs have been shown to cause numerous negative health and developmental impacts for them. EBLL testing data helps to identify areas where children may be at greater risk of lead exposure, and can also help to identify areas where the housing stock may need to be improved to reduce potential exposure to lead-based hazards.

Emergency room and urgent care use (MDHHS)
  • Percent of hospital visits by children on Medicaid that were to an emergency room or urgent care
  • Percent of hospital visits that were to an emergency room by age
  • Percent of hospital visits that were to an emergency room by condition
  • This data shows the prevalence of children who are on Medicaid visiting the hospital, including the percentage of those visits that were to an emergency room or urgent care. This is important to understand because ERs and urgent cares tend to be far more expensive methods of administering and accessing health care, and high ratios of ER usage compared to other hospital visits may indicate that children in an area have less access to primary care doctors.
  • Breaking the data into age buckets for younger and older children provides insight into any nuances that occur with these two groups.
  • This data can also be used to help identify specific factors that may be driving health crises for children, such as asthma or diabetes, which can then be used to inform and tailor outreach efforts to better support these communities.

Health insurance
  • Persons without health insurance
  • Percent uninsured by age group
  • Identifying the percent of the population who are without health insurance is important in helping direct potential funding, support systems, and resources to these areas. Organizations that provide low-cost or free health services could identify these areas as priority locations for their services, or for focusing additional outreach efforts.

Methodology

American Community Survey Data

The American Community Survey added questions about health insurance in 2008. Edits were made to the health care questions in 2009 that make direct comparison with the first year responses impossible without adjustments. In 2012, tables were added to count health insurance coverage for people aged 19 to 25.

The simplest source for data about coverage is table C27001. This table divides males and females into three age brackets: children (under 18), senior citizens (65 and older), and adults (18-64). For each combination of sex and age, there are simply two columns: covered, or not covered. The B27001 table provides finer grained detail, with nine age brackets. These tables are also provided in the nine standard racial iterations.

Tables B27002/C27002 through B27009/C27009 are structured indentically, but only count specific types of coverage. There are no racial iterations for these tables.

From the Census: Why We Ask: Health Insurance Coverage

Sample Survey Questions on this Topic

Code

Title

Health Insurance
B27001†‡ Health Insurance Coverage Status by Sex by Age
B27002‡ Private Health Insurance Status by Sex by Age
B27003‡ Public Health Insurance Status by Sex by Age
B27004‡ Employer-based Health Insurance by Sex by Age
B27005‡ Direct-purchase Health Insurance by Sex by Age
B27006‡ Medicare Coverage by Sex by Age
B27007‡ Medicaid/Means-tested Public Coverage by Sex by Age
B27008‡ Tricare/Military Health Coverage by Sex by Age
B27009‡ VA Health Care by Sex by Age
B27010‡ Types of Health Insurance Coverage by Age
B27011 Health Insurance Coverage Status and Type by Employment Status by Age
B27012‡ Health Insurance Coverage Status and Type by Work Experience by Sex by Age
B27013‡ Private Health Insurance by Work Experience by Sex by Age
B27014‡ Public Health Insurance by Work Experience by Sex by Age
B27015 Health Insurance Coverage Status and Type by Household Income in the Past 12 Months (In 2012 Inflation-adjusted Dollars)
B27016‡ Health Insurance Coverage Status and Type by Ratio of Income to Poverty Level in the Past 12 Months by Age
B27017‡ Private Health Insurance by Ratio of Income to Poverty Level in the Past 12 Months by Age
B27018‡ Public Health Insurance by Ratio of Income to Poverty Level in the Past 12 Months by Age
B27019 Health Insurance Coverage Status and Type by Age by Educational Attainment
B27020 Health Insurance Coverage Status and Type by Citizenship Status
B27021 Health Insurance Coverage Status and Type by Living Arrangement
B27022 Health Insurance Coverage Status by Sex by Enrollment Status for Young Adults Aged 19 to 25
B27023 Private Health Insurance by Sex by Enrollment Status for Young Adults Aged 19 to 25
‡Table also available in "collapsed" version: change "B" to "C" for table code.
†Tables B27001, C27001 also available in racial iterations.

Michigan Department of Health and Human Services Data

Deaths

The deaths dataset contains a row for each death in the State of Michigan. Each death record contains geographic information such as a Census Tract or latitude and longitude. When latitude and longitude were provided for a death, D3 tagged the record with the related census tract and then added all of the deaths in that tract together. Where this was not available the record was removed.

Profile pages include data on the number of infant deaths (defined as death before age one), unsafe sleep related infant deaths (ICD-10 code W75), and infant deaths due to assault or maltreatment (ICD-10 codes X85 - Y09) collected by the State of Michigan Office of Vital Statistics at the state, county, county subdivision, and congressional district levels in Michigan.

Columns

Description

Infant Mortality Data: D3-Infant-Mortality table
InfantMort Total number of infant deaths
SafeSleep Number of unsafe sleep related deaths
AssaultMal Number of assault or maltreatment related deaths

Elevated Blood Lead Levels

Data on tests for elevated blood lead level is collected by the Michigan Department of Health and Human Services at the individual level. For this analysis, D3 anonymized the data and aggregated it up to various geographies. Geographies with fewer than 6 individuals with elevated blood lead levels are suppressed (or removed) to protect anonymity. EBLLs are defined as a blood lead level 3.5 micrograms per deciliter or greater (the unit of measure used to determine lead levels which is micrograms of lead per deciliter of blood).

The table D3-Blood-Lead houses data on the following columns:

Columns

Description

Blood Lead Levels Data: D3-Blood-Lead table
CntTested Number of individuals who were tested
EBLL Number of individuals tested with an elevated blood lead level, defined as ≥ 3.5 micrograms per deciliter
Under6CntTested Number of individuals, under 6 years of age, who were tested
Under6EBLL Number of individuals tested, under 6 years of age, with an elevated blood lead level, defined as ≥ 3.5 micrograms per deciliter
Under18CntTested Number of individuals, under 18 years of age, who were tested
Under18EBLL Number of individuals tested, under 18 years of age, with an elevated blood lead level, defined as ≥ 3.5 micrograms per deciliter

Immunizations

Data on the number of fully or partially immunized people collected by the Michigan Care Improvement Agency at the county, county subdivision (in Wayne County), congressional district, State House district, State Senate district, and Census tract levels in Michigan. For this analysis, MDHHS determined immunization status using a National Immunization Survey (NIS) - like methodology, which is a count of both valid and invalid doses. This allows for comparisons with other states. Full immunization, denoted as "fully immunized," includes 4 DTaP, 3 Polio, 1 MMR, 3 Hib, 3 HepB, 1 Varicella, 4 PCV, and 2 HepA vaccinations. Partial immunization, minus HepA and minus PCV, lack HepA and/or PCV vaccinations, respectively.

D3 receives the immunizations dataset from MDHHS as a tract level dataset containing counts of people for each series of vaccinations. For aggregation in the tool we sum the number of kids in the census tract that were complete for series 431331, 4313314, and 43133142 respectively.

Columns

Description

Immunization Data: D3-Immunization table
Immunization_Population Immunized children aged 19-35 months
Fully_Immunized_43133142 Number fully immunized
Partially_Immunized_4313314 Number partially immunized (minus HepA)
Partially_Immunized_431331 Number partially immunized (minus HepA and PCV)

Medicaid

The Michigan Department of Health and Human Services (MDHHS) collects data on patients under 18 years of age who visited the hospital through Medicaid. This dataset includes information about the number of these visits that were to the emergency room, as well as the number of visits that were related to asthma or diabetes. If there were fewer than 6 observations, the information is suppressed (or removed) for privacy reasons.

D3 received the Medicaid dataset as a tract level dataset containing a count of visits per census tract.

For aggregation in the tool: we summed the count of visits for each category: total hospital visits or emergency room visits, for condition (asthma or diabetes), and age group (4 and under or between 5 and 17).

Columns

Description

Medicaid Data: D3-Medicaid table
Under18_Tot Total number of hospital or ER visits through Medicaid for children (under 18)
FivePlus_Tot Total number of hospital or ER visits through Medicaid for children over 5
Under5_Tot Total number of hospital or ER visits through Medicaid for children under 5
AsthmaCt Total number of hospital or ER visits for children through Medicaid related to Asthma
Diabetes1Ct Total number of hospital or ER visits for children through Medicaid related to Type 1 Diabetes
Diabetes2Ct Total number of hospital or ER visits for children through Medicaid related to Type 2 Diabetes
DiabetesOtherCt Total number of hospital or ER visits for children through Medicaid related to other types of Diabetes (excluding Type 1 and 2)
Tot_Hosp_Visits Total number of hospital visits through Medicaid for children under 18
Under5_Hosp Total number of hospital visits through Medicaid for children under 5
Tot_ER_Visits Total number of ER visits through Medicaid for children (under 18)
FivePlus_ER Total number of ER visits through Medicaid for children over 5
Under5_ER Total number of ER visits through Medicaid for children under 5
PctOvr5ER Percent of total children over 5 who visited the ER through Medicaid
PctUndr5ER Percent of total children under 5 who visited the ER through Medicaid
PctAsthma Percent of total children (under 18) who visited the ER through Medicaid related to Asthma
PctDiabetes Percent of total children (under 18) who visited the ER through Medicaid related to Diabetes

The Census provides additional insight into why this data is collected, in their “Why We Ask Questions About” pages.