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National Poll Reveals Health Concerns for Children
by Kurt Metzger, Director
The sixth annual C.S. Mott Children’s Hospital National Poll on Children’s Health was just released. The survey asked adults about their top health concerns for children in their communities.
The top answer this year was “not enough exercise.” Not only is it number one, but it is new to the top of the list. Childhood obesity and tobacco use were the second and third most commonly identified child health problems. Drug abuse fell out the top three to fourth place.
As in past years, many of the top ten health concerns relate to health behaviors: exercise, obesity, smoking and tobacco use, drug and alcohol abuse, pregnancy, and bullying. Top health concerns this year also include stress, internet safety, and abuse and neglect.
This year, other child health concerns rated as a “big problem” include: sexting (19%), driving accidents (18%), sexually transmitted infections (17%), school violence (16%), unsafe neighborhoods (16%), attention deficit disorder (15%), chemicals in the environment (15%), depression (14%), suicide (13%), racial inequality (13%), autism (13%), gun related injuries (11%), hunger (9%) and food allergies (6%).
Respondents of all races listed insufficient exercise and obesity as two of the top three health concerns for children in their communities. Other concerns that made the top ten across races included drug abuse, smoking and tobacco use, bullying, and teen pregnancy.
However, there are consistent differences in responses based on race and ethnicity. Hispanics were more concerned than blacks and whites about obesity, drug abuse, bullying, stress and pregnancy. Blacks were more concerned than whites and Hispanics about smoking and tobacco use, racial inequality, gun-related injuries and unsafe neighborhoods. Blacks and Hispanics both identified sexually transmitted infections as a greater concern than whites did.
These differences in perspective offer insights into ways that child health varies across communities, and they emphasize the need for local programs that respect and address community-specific health priorities for youth. Where you live should not determine how well or how long you live.
Data Driven Detroit (D3) is dedicated to documenting the characteristics of neighborhoods where adults live and children grow up so that issues of equity can be better addressed. We are currently working with the Detroit/Wayne County Health Authority to explore whether we can develop a collaborative effort to acquire data that will allow us to develop Healthcare and Population Needs Indices. We will also have the opportunity to work this fall with the Kirwan Institute at Ohio State University to redo the Neighborhood Opportunity Index for southeast Michigan that they published nearly four years ago.
Each of these indices will provide a lens through which we can better understand the neighborhood context in which people live, with the ultimate goal of creating opportunity in every neighborhood.
Need Data? See If D3 Already Has You Covered
by Kurt Metzger, Director
The August/September issue of Global Trade Magazine features a story on the Top 50 Cities for Global Trade. They describe it as “really two rankings in one. The overall ranking lists the 50 largest metropolitan areas  by export volume” along with “a set of superlative rankings selected by the editors at Global Trade.”
I am happy to report that, not only did the Detroit-Warren-Livonia metropolitan area rank #4 among the fifty in volume of trade ($44 billion) – one of those good news items we are always searching for – we also received the superlative of most improved!
The magazine summed up our global footprint as the following:
The International Trade Administration’s report on the highest-volume exporters by metropolitan areas showed that Detroit exports exploded by 55 percent during 2009 and 2010, the best growth rate in the country according to the most recent data available. Detroit sends a whopping 71 percent of its exports to North America Free Trade Agreement (NAFTA) countries, and—as expected—transportation equipment topped the list of the city’s exports, with $28.8 billion, or 66 percent of its $44 billion total export volume. The second spot was claimed by machinery with 9 percent. Respectable, but a footnote by comparison. Three of Michigan’s 20 Fortune 500 companies hail from Detroit, with General Motors ranking highest at the fifth spot on the prestigious list. Livonia adds another with TRW Automotive Holdings, which surely lends to the high percentage of the area’s auto exports. It’s also interesting to note that, despite being able to hit Canada with a stick thrown from Detroit, Mexico stands as Detroit’s leading export market, outpacing our northern neighbors by about $700 million.
This article was certainly good news for metro Detroit, but it reminded me of the need for Data Driven Detroit and the larger Detroit community to tell Detroit’s story ourselves. That’s something that we’ve been trying to do through our One D Scorecard. It began as a component of the One D collaborative, but maintenance of the Scorecard has persisted even after the collaborative has run its course. While we continue to look for sponsors to support data collection and interactive web development for the Scorecard, we also look for partners who are interested in using its data to aid the Detroit region.
We have divided our data across five major topic areas or “buckets” – Educational Preparedness, Economic Prosperity, Quality of Life, Social Equity, and Regional Transit. Within each is a set of indicators (which we are always interested in expanding) which provide rankings and downloadable data sets. When possible, we compare the 9-county Detroit CSA with the other 53 largest metropolitan areas in the country. In some cases, we are working with the 6-county MSA and, when necessary, occasionally we can get no smaller than the State of Michigan against all other states. Our goal is to expand the geography to county level and city of Detroit, where appropriate.
International Trade and Exports is one of the metrics we have been following in the Economic Prosperity section. Looking at the trend for the Detroit-Warren-Livonia metropolitan area since 2005 (the earliest year available), one can see the effect that the auto industry has on our export success, and clearly understand why Global Trade gave us the medal for Most Improved. The 2010 rebound brought us back to a level just below that in 2006 (when one adjusts 2006 to 2010 dollars).
Tracking the metro area’s export volume as a share of the state’s total finds that Detroit’s share was highest (74 percent) in 2006 and had fallen to 64.4 percent in 2009. The rebound in 2010 brought us back to 70.4 percent.
With our volume being relatively constant, our ranking among metros has been so as well. We ranked 4th in 2005, behind New York, Houston and Los Angeles (as we are in 2010), fell to 5th behind Seattle in 2006, stayed there for 2007 and 2008, and then dropped to sixth in 2009 as Miami-Ft. Lauderdale passed us momentarily.
As the article said, Detroit’s top partner in 2010 was Mexico with exports of $15.9 billion. Detroit led all metros in exports to Mexico. We also led all others in shipments to Canada, but the total was just below that for Mexico – $15.2 billion.
There is more where that came from. Help us build the OneD Scorecard together. We value all contributions – whether they are ideas, data or dollars
 Once again, we see the proclivity of publications (Forbes is always guilty) of describing their work as a ranking of cities when they are actually looking at metropolitan areas. In our case we are talking about the City of Detroit vs. the much larger 6-county (Lapeer, Livingston, Macomb, Oakland, St. Clair and Wayne) area. In many metropolitan areas, the difference between geographic, population and business dynamics is even greater than Detroit’s.
Nonprofits Take Steps to Measure Their Outcomes, And You Can Too!
by Kurt Metzger, Director
The Boston Globe had a story the other day about the growing number of nonprofits that have begun tracking outcomes in an effort to improve their performance and demonstrate their value to donors.
Nonprofits are using methods favored by for-profits, such as keeping detailed databases and measuring outcomes. The business-like approach has been in use at some nonprofits for some time, but it became more important during the recession, when donations dropped and assets eroded. Since then, more charitable foundations and government agencies have been demanding hard evidence that the programs they support better people’s lives. Social service organizations are gathering more information about participants, seeking outside analysis, and tracking their effectiveness to improve their performance — and prove their worth.
“The economic downturn has put fewer dollars in the hands of philanthropic interests and contributed to a more competitive funding landscape for nonprofit organizations,” said Adrian Bordone, cofounder of Social Solutions, a Baltimore company whose performance management software is being used by more than twice as many human services organizations now compared with four years ago. “This has forced organizations who have in the past depended on anecdote and compassion to propel their fund-raising success to more aggressively pursue a data-based value proposition.”
Companies like Social Solutions produce software packages that are increasingly used by large nonprofits like LISC and United Way to measure the outcomes of their programs. For smaller nonprofits, however, these software packages can be too expensive. There are lower-cost alternatives that can get nonprofits up and running in utilizing the data they already collect. Consultants and nonprofits alike believe the knowledge gleaned from the data makes it easier for them to demonstrate their value to funders and increase the number of people who benefit from their programs.
Data Driven Detroit’s mission is to provide better data for better decision making. We want to assist organizations to better measure their effectiveness so that they can more readily and effectively tell their story to their clients, their funders, and the public at large.
Measurement provides tangible evidence of progress which, in turn, motivates you to keep at it. This is true whether your goal is physical fitness or fund raising, environmental health or literacy. Measurement helps you know where you are now, and get to where you want to be. D3 is here to help
“If you aren’t measuring what you’re doing, then you’re not evolving what you’re doing,” said Elisabeth Babcock, president of the Crittenton Women’s Union in Boston, which has been able to improve its program results and strengthen its donor base through the collection and analysis of performance data. “In the for-profit world, companies live or die by whether or not they’re getting better at what they deliver, and in the nonprofit world, we need to be doing the same.”
New Analysis Ranks States, Finds 12 Top Exceed 30 Percent for Obesity; Michigan Ranks 5th Highest
by Kurt Metzger, Director
Twelve states currently have an adult obesity rate above 30 percent, according to a new analysis released by the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) earlier this week (8/14/12). The analysis used the state obesity rates released by the U.S. Centers for Disease Control and Prevention (CDC). Mississippi had the highest rate of obesity at 34.9 percent, while Colorado had the lowest rate at 20.7 percent. Twenty-six of the 30 states with the highest obesity rates are in the Midwest and South. Michigan ranked 5th most obese with a rate of 31.3 percent.
“Obesity has contributed to a stunning rise in chronic disease rates and health care costs. It is one of the biggest health crises the country has ever faced,” said Jeffrey Levi, PhD, TFAH executive director. “The good news is that we have a growing body of evidence and approaches that we know can help reduce obesity, improve nutrition and increase physical activity based on making healthier choices easier for Americans. The bad news is we’re not investing anywhere near what we need to in order to bend the obesity curve and see the returns in terms of health and savings.”
A ranking of State by State Adult Obesity rates is available here.
Later this summer, TFAH and RWJF will release the 2012 edition of “F as in Fat,” the annual report that analyzes state obesity rates and policy efforts to address the epidemic, and provides policy recommendations. For the first time, the 2012 report will include a study that forecasts 2030 obesity rates in each state and the likely resulting rise in obesity-related disease rates and health care costs.
In 2006, obesity-related medical costs totaled $147 billion a year, or nearly 10 percent of total medical spending, according to a 2011 study in Health Affairs. The bulk of the spending is generated from treating obesity-related diseases, such as diabetes.
“Our nation has made important inroads to creating healthier communities,” said Risa Lavizzo-Mourey, MD, MBA, RWJF president and CEO. “Some cities and states that have taken comprehensive action to address the epidemic are beginning to see declines in their obesity rates. But we need to expand and intensify our efforts. Investing in prevention today will mean a healthier tomorrow for our children.”
In recognition of the dramatic health and financial consequences of obesity, the Institute of Medicine (IOM) earlier this year released a comprehensive report that outlined strategies for reversing the epidemic and called on everyone to advance those strategies. The IOM committee, made up of nutritionists, public health experts, and leaders from the public, private and nonprofit sectors, called for a focused commitment to: making physical activity an integral and routine part of life, creating food and beverage environments that ensure that healthy food and beverage options are the routine, easy choice, transforming messages about physical activity and nutrition, expanding the role of health care providers, insurers and employers in obesity prevention, and making schools a national focal point for obesity prevention.
While Data Driven Detroit supports all the recommendations of the IOM committee, we also realize that poverty, literacy, crime, and limited food options are highly correlated with obesity. Addressing obesity means addressing education and creating strong, safe neighborhoods.
A quick analysis of the adult population at the state level shows that obesity is negatively correlated with educational attainment and positively correlated with poverty. These findings show that this is more than just a matter of “craft the message and they will follow.” Obesity is not simply a choice; there are many factors that contribute to it. The place to start is at home – the neighborhood level. We must work to create opportunities in all neighborhoods and to close the education and socioeconomic gaps that we continue to see in Michigan and across the country.
The 2011 “F as in Fat” report is available on TFAH’s website at: healthyamericans.org; the upcoming 2012 “F as in Fat” report will be released later this summer.
Natural Decrease: Michigan’s Efforts to Increase Population Thwarted by Decreasing Births and Increasing Deaths
by Kurt Metzger, Director
Now that the Michigan Department of Community Health has released the death numbers for 2010, Data Driven Detroit has analyzed the decade’s trend and its effect on population change in the State. Michigan has been losing population annually since 2005, according to the Census Bureau. The 2010 – 2011 loss was the smallest of the six we have suffered, surpassed for the first time by another state – in this case, Rhode Island.
This population change is driven by two components: migration and natural increase.
While immigration continues to supply about 18,000 new residents a year to the state (18,347 in 2011), domestic outmigration – more Michiganders moving out-of-state than out-of-staters moving into Michigan – overwhelmed these gains. The net loss is directly affected by economic conditions, with recent improvements leading to a decrease in the net outflow.
The other component of population growth is called Natural Increase, which equates to the number of births minus the number of deaths. The annual trend for 2000 – 2010 is shown in Table 1.
Table 1. Michigan Births, Deaths and Natural Increase, 2000 – 2010
Table 1 demonstrates the decreasing contribution that natural increase has made to the population in Michigan over the decade. Whereas natural increase added 49,060 persons to the state’s total in 2000, only 26,659 were added in 2010. This represents a decrease of 45.7 percent, driven by the combination of a 15.7 percent decrease in births and a 1.2 percent increase in deaths. Michigan’s age structure in 2010 provides a clear picture as to why we can expect a continuation of these trends. Birth rates have been decreasing nationally and Michigan ranks 8th lowest in the nation. Our state ranking in percent of the population 45 years and over (at the upper limit of the child-bearing years) rose from 30th in 2000 to 10th in 2010! How can we expect our births to increase when our child-bearing population is decreasing?
When we begin to dissect the state into its component counties, we find that 38 counties, concentrated in the Upper Peninsula and Northern Lower Peninsula, experienced more deaths in 2010 than births. The term Natural Increase has been turned on its heels to Natural Decrease. While a number of counties experienced greater declines in their natural increase, St. Clair County experienced the biggest flip. In 2000, the county’s 2,180 births and 1,471 deaths resulted in a net increase of 709. By 2010, births had decreased to 1,625 and deaths had increased to 1,642. The 2010 net was an actual loss of 17 residents in St. Clair County.
All the larger counties, as well as the City of Detroit, experienced double-digit percentage decreases in the number of residents being added through natural increase. The lowest decreases came in Kalamazoo (-17.1%), Washtenaw (-17.5%), Kent (-20.0%), Ottawa (-21.6%), and Ingham (-23.3%) counties. These were followed in order by:
Out-Wayne County -43.8%
Detroit city -40.9%
Oakland County -52.0%
Genesee County -52.9%
Macomb County -54.8%
Livingston County -57.9%
While an improving economy will help stabilize our residential base, it will be critical for Michigan to begin to attract more residents in their 20s. We lead the nation in the percentage of our 18-34 year olds who were born in their current state of residence. This number one ranking is not something to wave in the air; it means that 18-34 year olds from elsewhere are not seeing Michigan as a destination state. Unless we can begin to lower our rate and ranking in this important demographic, we will not be able to increase our birth numbers nor our overall population.
A detailed database that fueled this analysis is available upon request.