STATE’S MOST DIVERSE VOTING BLOC IS DIVIDED
Trump gains among Black men as Gaza war looms over Biden
Wayne County stands out as Michigan’s most racially and ethnically diverse. And how it votes — or rather how many vote — could decide the presidential election.
Michigan’s largest county provides Democratic candidates their biggest voting bloc. But if the county represents the heterogeneity of the party’s coalition, it also demonstrates the divides tearing it apart.
No doubt, Wayne County will deliver a large chunk of Democratic votes this fall. The last time a Republican presidential candidate won the county was in 1928 when Herbert Hoover carried it. In 2020, President Joe Biden won 68% of its votes. Some residents have already turned out enthusiastically to keep the president in office for another term.
When retired auto mechanic Brian Jourdan, 65, of Detroit, went to go vote at Greater Grace Temple on Detroit’s west side during Michigan’s presidential primary in February, he decided to dress for the occasion. “It wasn’t rigged. You’re just a loser,” read the text on his blue sweatshirt in reference to former President Donald Trump’s misinformation campaign to overturn his 2020 loss. “I’m ashamed that guy was ever our president,” said Jourdan of Trump.
“Biden’s done me a lot of good,” he said, pointing to lower costs for his prescriptions that have saved him money. But he did register one complaint. “I don’t care for the Israel thing that much if I was going to be critical of him,” he said. It seems to him like the Palestinians are “always getting screwed.”
While Democrats dominate Wayne County, it
'We are failing Black women'
“The areas in which we as a country are failing are on maternal and infant health," said Bagdasarian. “So our maternal mortality is the highest compared to other high-income countries.
“If we look at Black women in the United States, we are many-fold worse than our closest comparators. We are failing Black women when it comes to maternal mortality. We are failing Black infants when it comes to infant mortality. And again, this is across the board.”
Outcomes for Black mothers and babies are indeed grim. The Black infant mortality rate in Michigan was found higher than the national rate, with 13 infant deaths per 1,000 live births. The death rate is more than twice that of Latino, Asian and white babies, the report showed.
Besides infant mortality, the report evaluated adult obesity, cancer rates and screenings, out-of-pocket medical spending, preventable hospitalizations, emergency room visits and the cost of health care.
Where a person lives matters, noted the researchers, who called their report a roadmap for targeted federal and state policy solutions. Poverty, food insecurity, exposure to pollution and crime are prevalent in many communities where people of color live and green spaces are few, they said.
Black Michiganders face premature death from preventable causes
“This report demonstrates that if you don’t look under the hood, you won’t identify where you’re failing people and where you're leaving people behind,” said Dr. Joseph Betancourt, president of the Commonwealth Fund, which has tracked health and health care in every state for nearly two decades.
Safe housing, education and employment opportunities can also impact health equity. These factors can have a greater influence than genetics or access to health care services.
Achieving equity requires bold policy action, researchers said. Numerous studies have shown that many patients of color contend with discrimination in health care settings and more often receive worse medical care than white patients, according to the report.
“Health care systems can have the opportunity to have strong reporting systems and reconciliation systems that center equity and providing
accountability to ensure that there’s an easy way, for example, to anonymously or even transparently report situations involving racism or discrimination,” said Dr. Laurie Zephyrin, the Commonwealth Fund’s senior vice president for advancing health equity.
Racial disparities in health care for Black and Native Americans are longstanding, with life expectancy shorter, on average. COVID-19 made things worse.
In Michigan, the data show that Black people are most likely to die prematurely from preventable causes, with 440 deaths for every 100,000 people. American Indians/Alaska Natives are also more likely to die early from preventable causes, with 314 deaths for every 100,000 people in Michigan.
Although Black people in the study had higher rates of deaths from preventable causes and infant mortality, most were insured.
Can policy changes close the gap?
This data raises questions on how residents perceive, access and interact with the health care system, said Phillip Levy, a physician and professor of emergency medicine at Wayne State University.
“Just because you have health insurance doesn’t mean you have the transportation to get to an office,” Levy said.
Since the Affordable Care Act became law in 2010, access to health care has improved, yet remains unattainable for many. Latino adults were found more likely in every state to skip health care because of costs, with higher rates of medical debt.
“When we looked at data that 25 million people in the United States are still uninsured, and they’re disproportionately people of color. And even for people who are insured about a quarter of working-age adults are underinsured. They’re really facing high out-of-pocket costs and deductibles, relative to their income, which really makes them not come in for care at all because they can’t afford it,” Zephyrin said.
Improving access and making health insurance more affordable is only part of the solution, she said.
Commonwealth Fund researchers also urged broad policy goals that would strengthen primary care; lower the administrative barriers for patients and providers and increase investments in social services such as housing and education.
Michigan has recently taken steps to address disparities, Bagdasarian said, by expanding Medicaid coverage for mothers and babies. The state also has established regional coalitions of community members and health and social care professionals that will address housing, transportation and nutritional needs.
Massachusetts, Rhode Island, Connecticut, Hawaii, New Hampshire and New York had better-than-average health care performance for all groups. Oklahoma, Arkansas, West Virginia and Mississippi had health care scores below average among all groups.
The analysis was conducted using publicly available databases reporting outcomes from more than 328 million people during 2021 and 2022.