Michigan has great access to health care. Health outcomes are another story

Like much of the Midwest, Michigan is more obese and less healthy than the rest of the nation. The state has terrific rates of insurance, immunization and primary care physicians, though, making the state’s overall health a bit of a puzzle. (Shutterstock image)


Michigan has some of the best access to health care in the nation, but like much of the Midwest, ranks in the bottom third of the nation in overall personal health.

It’s a dichotomy that has persisted for decades, as a tradition of good-paying, union jobs has provided a better network, on average, of hospitals, insurance and access to primary care doctors than the rest of the nation.

Even so, Michigan ranked 32th in overall health in 2019, according to the United Health Foundation, a Minnesota-based nonprofit that works to improve public health. 

And the rankings predate the greatest health crisis in a century: the coronavirus pandemic, which has killed more than 220,000 people nationwide since March. Early in the pandemic, Michigan was one of the hardest-hit states, and ranked 10th in deaths on Oct. 19, which is roughly proportionate to its population.


As a state, Michigan has higher rates than the national averages for smoking (19 percent vs. 16 percent); drug deaths (23.9 per 100,000 vs. 19.2) and heart disease deaths (300 per 100,000 vs. 260). Life expectancy in Michigan was a full year less than the national average (75.2 for men, 80.2 for women), according to state statistics.

Still, Michigan ranks high among states nationwide in access to insurance in the nation (No. 7), the number of primary care physicians (No. 6) and immunization rates among adolescents (No. 5).

The discrepancy has persisted for years, but some critics say it’s been exacerbated by a disinvestment in public health. 

Michigan is in the Top 10 for the least amount of money spent per capita on public health, according to a 2017 report from the nonpartisan Citizens Research Council of Michigan. Since 2004, state-supported spending on health has dropped 16 percent when adjusted for inflation, the report found.


What lawmakers are doing

Michigan’s boosted access to insurance by extending Medicaid to more than 600,000 people through the Healthy Michigan program as part of the 2010 Affordable Care Act, or Obamacare. 

In January, Michigan joined nine other states to implement rules requiring adults who receive the benefit to work at least 80 hours a month or document why they can’t. The rules would apply to some 238,000 Michiganders.

Similar rules in other states have sparked lawsuits, accusations of thousands losing insurance and overall uncertainty. But Republican backers of the plan in Michigan say it’s a commonsense reform to ensure those receiving benefits get off public assistance.

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Mon, 02/10/2020 - 8:07am

Obviously need to pass a law requiring exercise, healthy eating and regular check ups!

Thu, 02/13/2020 - 5:05pm

I don't think we need a law, Matt, but we certainly need common sense. Michigan is not unique in having high rates of obesity, smoking, and other self-inflicted (in many cases) health issues. Money budgeted for incentives to get people to exercise, eat healthier, maintain a healthy weight, etc., would be money well spent, and as much as I hate paying people to do what they should have sense enough to do in the first place, the end result would be significant savings in health care costs. While I don't believe in abandoning care for people with health issues by any means, it galls me to know my tax dollars are going to pay for health care for people who have conditions related to addiction, obesity, poor diets, lack of exercise, etc., when they have at least some control over their lifestyle choices. And before all the haters accuse me of not understanding, etc., yes, I know addiction is horribly hard to overcome. Yes, I know it is difficult to make healthy food choices when people have limited income, lack transportation to stores, etc. Yes, I know that sometimes obesity is genetic or caused by other factors beyond one's control. But more emphasis on healthy lifestyle choices would go a long way towards addressing this growing health care crisis.

Robyn A Tonkin
Tue, 10/20/2020 - 10:28am

Personally, I don't think you need to sort of apologize for your comment. What you wrote expressed complete respect for other people. One thing I don't think we always need to do when examining obesity is to default to issues that face the poor and people of color--lack of good stores, lack of transportation, lack of wellness care, the list goes on. I know people who are educated, drive late model cars and who grocery shop at high end health food stores--and who are morbidly obese and love every minute of it. They don't want to so much as walk to the corner for exercise, and they tell me that they made themselves miserable dieting when they were younger, and now they just love living to eat, and they only eat foods they want to eat, in the amounts they want. For the people I am thinking of, what they want is big dishes of ice cream. People don't want to make healthy lifestyle choices and get into fitness because they don't find it fun. Full stop. Being slim and fit is a "lifestyle choice" but it is such a huge one, and so completely ecompasses everything in your life, that "choice" is sort of a poor analogy. The road forks, and you take the fitness trail, and it diverges so fast from the current American norm that very rapidly, you can't see the other road at all anymore. The chronically obese people I know, the weight losers, then bigger gainers, the diet yo-yo-ers, have zero genuine commitment to changing their lives that much. Basically, if you are well into adulthood, you have start over and build a new life, and they don't want to do that.
As far as addiction goes, I was raised that you do not bring shame on yourself or your family by sinking to certain depths. Boy! Is that so-o-o gone, because of the industry that has sprung up around the "disease-ing of America." One thing that always stands out is that so often when people do manage to "get clean" , that they stay in the AODA line of work. Why not take your new sobriety, and do something else, something completely divorced from facing the drama of addicted people every day?

Something else about doing something really hard--stopping drinking, or taking drugs, or losing 150 pounds--you are not always going to have a "support network" available when you need it. sometimes, you are going to have to stand on your own two feet and find the strength within yourself to handle some crisis that has come up--it's called "a personal growth moment", and also, "independent adult behavior". Not always having somebody to hold your hand is not an excuse for giving up.