Assessment of the health and nutrition of Latinos/Hispanics in Washtenaw County,

Michigan
By Alison Sheets
Demographic and economic Data
The distribution of gender is split with 49.3% male and 50.7% female (12). Michigan has
a median age of 39 while the median age of Washtenaw county is 33 and the distribution in the
county is as follows (12):

Table 1 (adapted from U.S. Census Bureau, American Fact Finder 2016; data available at
http://factfinder.census.gov/)

As shown in table 1, the largest age group for both men and women in Washtenaw
County, Michigan is 20 to 24 years old (12). The second largest age group is 15 to 19 years of
age followed by 25 to 29 and so forth (12). Working age adults make up approximately 60.1% of
the population in Washtenaw County which is part of the subpopulation of interest for this needs
assessment (12).

Figure 2 (adapted from U.S. Census Bureau, American FactFinder 2010; data available at
http://factfinder.census.gov/ )

As shown in figure 2 the population in Washtenaw County in terms of race, largely

reflects the population of Michigan. Michigan and Washtenaw are predominantly white. Of the
population in Washtenaw County, 74.5% is white, while 78.9% of Michigan is white (12). The
Hispanic/Latino population in Michigan makes up 4.4% of the total population while in
Washtenaw county Hispanics/Latinos make up 4% of the population as of 2010 (12).
In Michigan, according to data from 2015, 69.8% of people of Hispanic or Latino origin
are high school graduates or higher, however, only 16.4% have a bachelor’s degree or higher
(13). More people of Hispanic/Latino origin in Washtenaw county have graduated from high
school or higher, 82.2% respectively and attained a bachelor’s degree or higher, at 33.9% or
higher (13).
 Figure 3 (adapted from U.S. Census Bureau, American FactFinder 2011-
2015; data available at http://factfinder.census.gov/ )

As shown in Figure 3, the sales and office occupations (represented by the two bars on
the far right of the figure), represent 19.96% of the occupations in Washtenaw county and 23.7%
of occupations in Michigan overall (13). These occupations are followed by the service
occupations; education, legal, community service, arts and media occupations; and finally
Management, business and financial occupations (13). Figure 3 demonstrates that Washtenaw
county has significantly more education, legal, community service, arts and media occupations
than Michigan in general (13).
Figure 4 (adapted from U.S. Census Bureau, American FactFinder 2015; data available at
http://factfinder.census.gov/ )

Overall, as shown in Figure 4, Hispanics or Latinos have the second highest percentage of people
living at or below the poverty level in Washtenaw County at 23.8% (14). It was also found that
an estimated 11.9% of Hispanic or Latinos in Michigan live at less than 50 percent of the poverty
level and 27.1% live at less than 100 percent of the poverty level in Michigan(14). In
comparison, in Washtenaw county 10.7% of Hispanics or Latinos live at less than 50 percent of
the poverty level and 23.8% of Hispanics or Latinos live at less than 100 percent of the poverty
level (14).
Figure 5 (adapted from U.S. Census Bureau, American FactFinder 2015; data available at
http://factfinder.census.gov/ )

Displayed in figure 5, of the Hispanics/Latinos in Washtenaw county, as of 2015, 63.6%

are employed(14). Whereas, 7.9% of Hispanics/Latinos in Washtenaw county in 2015 were
unemployed(14). Washtenaw county has a lower unemployment rate for Latinos/Hispanics,
which is 12.4% in the state of Michigan as of 2015 (14). The employment rate for
Latinos/Hispanics in Michigan as of 2015 is 59%(14).
The median household income in Michigan is $49,576, in Washtenaw County however,
the median household income is $61,003(14). Meanwhile, the median family income for
Michigan is $62,247 and for Washtenaw County it is $87,331 (14). The percentage of families
that rent homes in Michigan is 29% as of 2015 (14). The percentage of families that own homes
in Michigan is 71% as of 2015 (14). In comparison, the percentage of families that rent homes in
Washtenaw County is 40.2%, and the percentage of families that own homes in Washtenaw
County is 59.8% as of 2015(14). This relates back to Hispanics and Latinos in Washtenaw
County, the population of interest in this needs assessment because it indicates that the cost of
living in Washtenaw County is higher than other areas in Michigan. This data also indicates that
more people are renting rather than buying and investing in homes in Washtenaw County in
comparison to the state of Michigan.

Health statistic data

As can be seen from the graph in Figure 6, the all causes age adjusted death rates in
Washtenaw County are overall, less than that of Michigan (15).

Figure 6 (Adapted from the 1980-2015 Michigan Resident Death Files, Division for Vital
Records & Health Statistics, Michigan Department of Health & Human Services; data available
at
https://www.mdch.state.mi.us/osr/chi/CRI/CriticalInd/Crilhd.asp?TableType=All%20Causes&C
oName=Washtenaw%20County%20Health%20Department&CoCode=48)
Table 2 (Adapted from Leading Causes of Death By Age, Washtenaw County Health
Department, Michigan 2015; data available at
https://www.mdch.state.mi.us/osr/chi/Deaths/31DP/MiniDPObject.asp?AreaCode=48&AreaTyp
e=L&JS=No)

As can be seen from Table 2, the leading cause of death in Washtenaw County as of
2015 is heart disease across all ages. In comparison, it was found that as of 2015, the top five
leading causes of death for all ages in Michigan were, in descending order: diseases of the heart,
malignant neoplasms, chronic lower respiratory diseases, and accidents (16). This information
provides more impetus for this needs assessment as heart disease has been linked to obesity (
17).

Figure 7 (Adapted from the 2015 HIP Survey: Washtenaw Adults – Cardiovascular Health; data
available at
https://healthsurveys.ewashtenaw.org/#/survey/question/HIP/2015/HrtAttck?category=Adult&gr
oupby=income3)
 In Washtenaw County, as of 2015, it was found that 4.4% of people surveyed with
an annual income of less than $20,000 reported they had had a heart attack and 4.7% whose
income is between $20,000-34,999 also reported having a heart attack (18). According to the
2015 Michigan BRFS Estimates by Race-Ethnicity, of those surveyed, 7% of Hispanics reported
being told that they had any cardiovascular disease (19). In comparison, in 2014, of the
Hispanics/Latinos surveyed in Washtenaw County, 2.5% reported having had a heart attack (8).
However, of the Hispanics/Latinos surveyed in Washtenaw County, 3.4% of those with an
income less than $20,000 reported having a heart attack and 5.2% reported having a heart attack
that also have an income of $20-$34,999 (8).

Figure 8 (Adapted from Prevalence Estimates for Risk Factors and Health Indicators by Race-
Ethnicity, State of Michigan; data available at
http://www.michigan.gov/documents/mdhhs/2015_MiBRFS_Race_Tables_FINAL_540220_7.p
df)

Figure 8 shows the percentage of people who have been told they have diabetes by
race in the state of Michigan. As can be seen in figure 8, 10.1% of Hispanics reported having
been told they have diabetes. In comparison, in Washtenaw county according to the 2014 EBV
Survey, 6.7% of Latino adults reported ever having diabetes and 2.1% reported having diabetes
only while pregnant (8).
The infant mortality rate from 2015 in Washtenaw County is 14 (20). This is
comparable to the infant mortality rate of Michigan which is 6.8 per 1,000 live births (21). This
is important to note because although findings have been inconsistent, it has been noted that a
higher maternal BMI may be associated with not only pregnancy complications such as
septicemia and gestational diabetes, but also infant mortality (22).
 Prevalence of adults with no
healthcare access due to cost
20.0%
18.0%
16.0%
14.0%
12.0%
10.0%
8.0%
6.0% Prevalence of adults with
4.0%
2.0% no healthcare access due
0.0% to cost

Figure 9 (Adapted from Michigan Coordinated Chronic Disease Prevention and Health
Promotion Indicators: Could not Afford to See a Doctor, 2015)

Figure 9 illustrates the prevalence of adults with no healthcare access due to cost.
As is shown in the graph, the majority of people who cannot access healthcare due to cost are
primarily aged between 25 and 44 (23). The percentage of adults in Washtenaw County who are
not able to access healthcare due to cost is approximately 11.3% (23). Washtenaw County’s
percentage of people not able to access healthcare due to cost is comparable to that of Michigan
as a whole at 12.7% (23).

Nutrition/Physical Activity
As shown in figure 10, 65.8% of the Washtenaw Latino adults surveyed in the EBV
survey are overweight or obese.

Figure 10 (Adapted from the 2014 EBV Survey: Washtenaw Latino Adults – Weight Status and
Physical Activity; data available at
https://healthsurveys.ewashtenaw.org/#/survey/question/EBV/2014/BMIcat4?category=Adult )
Similarly, as shown below in figure 11, Michigan is shown to have a prevalence of greater than
35% of the self-reported obesity among Hispanic adults. As can be seen in figure 11, Michigan
has a higher prevalence of self-reported obesity among Hispanic Adults than most other states
and territories. In addition to this, in Washtenaw County, according to figure 12, shown below,
most Hispanic/Latino adults who have reported being overweight or obese tend to be in West
Ann Arbor or Ypsilanti (8). This information is important as it indicates there is a need for the
prevalence of overweight or obesity to be addressed in these areas.

Figure 11 (Adapted from the Prevalence of Self-Reported Obesity Among U.S. Adults by
Race/Ethnicity, State and Territory BRFSS, 2014-2016; data available at
https://www.cdc.gov/obesity/data/prevalence-maps.html )

Figure 12 (Adapted from the 2014 EBV Survey: Washtenaw Latino Adults – Weight Status and
Physical Activity; data available at
https://healthsurveys.ewashtenaw.org/#/survey/question/EBV/2014/BMIcat4?category=Adult&g
roupby=regions5 )
 Figure 13 shows that in Washtenaw County, over 25% of Latino adults surveyed
have sugar sweetened beverages once a day or more and over 30% have sugar sweetened
beverages a few times per month or less (8).

Figure 13 (Adapted from the 2014 EBV Survey: Washtenaw Latino Adults –Food Consumption;
data available at
https://healthsurveys.ewashtenaw.org/#/survey/question/EBV/2014/SweetBev?category=Adult )

Figure 14 displays that over 60% of those surveyed in the EBV study in Washtenaw
do not consume five or more portions of fruit or vegetables per day (8). Figure 14 also indicates
that with a household income is less than $20,000, over 70% of those surveyed do not consume
five or more portions of fruit or vegetables today (8). In correspondence with this, 18.3% of
those Hispanics surveyed in the 2015 Michigan BRFS, responded that they consumed a fruit and
vegetable five or more times per day (19). This percentage is greater than that of Michigan in
total, which was found to be 14.4%. However it was demonstrated by the EBV study that of
those surveyed, 91.5% consumed a vegetable one or more times per day and 94.2% consumed
fruit once or more per day (8).

Figure 14 (Adapted from the 2014 EBV Survey: Washtenaw Latino Adults –Food Consumption;
data available at
Figure 15 (Adapted from the 2014 EBV Survey: Washtenaw Latino Adults –Food Consumption;
data available at

Figure 16 (Adapted from the 2014 EBV Survey: Washtenaw Latino Adults – Weight Status and
Physical Activity)
Figure 16 shows that of 2014 in Washtenaw County, 37% of Latino/Hispanic adults
surveyed reported not participating in any physical activity for exercise. In comparison, of the
Washtenaw adults surveyed in 2015, 23.2% reported not participating in any physical activity for
exercise (8). Moreover, it was also found that of the Latino/Hispanic adults surveyed in
Washtenaw County in 2014, 84.2% reported not having engaged in moderate physical activity
for 30+ minutes per day for 5+ days per week (8). This data indicates that Latino/Hispanic
adults, more than the general population, is not participating in physical activity for exercise.

Community Assets and Resources

Washtenaw County has a variety of assets and resources available to the public to
increase food access and reduce obesity. Washtenaw County Health Department has also
specifically compiled a comprehensive list of programs aimed at reducing obesity in Washtenaw
(). This list and directory can be found at:
http://www.ewashtenaw.org/government/departments/public_health/health-
promotion/hip/pdfs/2015-directory-of-obesity-prevention-programs (). It should be noted that
none of the programs listed in the directory are specifically tailored to different ethnic/racial
groups but may be available in different languages (). The resources and assets aimed at
increasing food access is as follows:
 SNAP
 Washtenaw County Health Department
 Double Up Food Bucks
 Prescription for Health
 WIC Project FRESH
 Senior Project FRESH
 Hoophouses for Health
 Washtenawmarkets.org
 Food Gatherers
 Ypsilanti Meals on Wheels
 St. Andrews Episcopal Church
 SOS Community Services
 Salvation Army
 Robert J. Delonis Center
 Hope Center
 First Baptist Church
 Catholic Social Services-Emergency Food Program
 Bryant Community Center
 Ann Arbor Meals on Wheels
 Ann Arbor Community Center
 Department of Health and Human Services

Resources and assets provided by the Michigan Department of Health and Human Services in
order to reduce obesity in Michigan are as follows:
 Michigan Personal Action Towards Health (PATH)
 Michigan, Physical Activity and Obesity Program
 WISEWOMAN Program
 Michigan Health and Wellness 4x4 Plan
 MI Healthier Tomorrow
Recommendation of Priorities Section
The data found in the demographic and economic data indicate that the percentage
of Latinos/Hispanics in Washtenaw County reflects that of Michigan at around 4% (12). The
data also shows that the majority of the population in Washtenaw county is of working age and
many of the Latinos/Hispanics in this county live at or below the poverty level (13). In addition
to this, the health statistics, gathered for this needs assessment, illustrate that a leading cause of
mortality in Michigan and in Washtenaw are medical issues with the heart; specifically heart
disease in Washtenaw county(16). Moreover it was found that 65.8% of Latino adults surveyed
in 2014 are overweight or obese (8). The nutrition/physical activity findings show that although
of those surveyed, 91.5% consumed a vegetable one or more times per day and 94.2% consumed
fruit once or more per day in the EBV study, the majority of Latino adults in Washtenaw county
were not engaging in physical activity for 30+minutes per day for 5+ days per week (8).
In light of this data and the available resources in Washtenaw County, it may be
beneficial to tailor available programs aimed at reducing obesity, increasing physical activity,
and increasing fruit and vegetable consumption towards specific minorities including
Latinos/Hispanics. Piloting a culturally tailored program would be key to ensuring its success.
Making these programs available in different languages and culturally tailored may increase their
usage by minority groups such as Blacks, Asians, Native Americans and Latinos/Hispanics. In
addition to the increased usage, the programs may also be seen as more effective in reducing
obesity/overweight in Washtenaw County and/or Michigan in general.
References
1. Centers for Disease Control and Prevention. (2017). Adult Obesity Facts. Retrieved from
https://www.cdc.gov/obesity/data/adult.html

2. Ogden C.L., Lamb M. M., Carroll M. D., and Flegal K.M. Obesity and Socioeconomic Status
in Adults: United States, 2005-2008. 2010 Retrieved from
https://www.cdc.gov/nchs/data/databriefs/db50.pdf

3. Anderson, B., Rafferty, A.P., Lyon-Callo, S., Fussman, C., and Imes, G. (2011). Fast-Food
Consumption and Obesity Among Michigan Adults. Preventing Chronic Disease, 8(4) 1-11.

4. MacNell, L., Elliott, S., Hardison-Moody, A., and Bowen S. (2017). Black and Latino Urban
Food Desert Residents’ Perceptions of Their Food Environment and Factors That Influence Food
Shopping Decisions. Journal of Hunger & Environmental Nutrition, 12(3) 375-393

5. Gregory, C. A., Coleman-Jensen, A. (2017). Food Insecurity, Chronic Disease and Health
Among Working-Age Adults. United States Department of Agriculture, Economic Research
Service

6. Centers for Disease Control and Prevention. (2017). BRFSS Prevalence & Trends Data.
Retrieved from
https://nccd.cdc.gov/BRFSSPrevalence/rdPage.aspx?rdReport=DPH_BRFSS.ExploreByTopic&i
rbLocationType=StatesAndMMSA&islClass=CLASS05&islTopic=TOPIC48&islYear=2016&r
dRnd=97622

7. National Institute for Children’s Health Quality. (2017). Healthy Lifestyles in Washtenaw
County, Michigan. Retrieved from https://www.nichq.org/resource/obesity-factsheets

8. Washtenaw County Community Health Data (2014). 2014 Encuesta Buenos Vecinos Latino
Health Survey, Retrieved from
https://healthsurveys.ewashtenaw.org/#/survey/question/EBV/2014/InterDiff?category=Adult

9. Gorman, K. S., Zearley, K. K., Favasuli, S. (2011). Does Acculturation Matter?: Food
Insecurity and Child Problem Behavior Among Low-Income, Working Hispanic Households.
Hispanic Journal of Behavioral Sciences

10. Medel-Herrero, A., Leigh, J. P. (2017). Changing SNAP-Participation Trends Among

Farmworker Households in the U.S., 2003-2012. Journal of Immigrant Minority Health

11. eWashtenaw (2017). Food & Meals, Retrieved from

http://www.ewashtenaw.org/government/departments/port/food

12. United States Census Bureau (2010). American FactFinder, Retrieved from
https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=CF
13. United States Census Bureau (2015). American FactFinder, Retrieved from
https://factfinder.census.gov/faces/nav/jsf/pages/community_facts.xhtml#

14. United States Census Bureau (2015). American FactFinder, Retrieved from
https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=CF

15. All Causes Deaths and Death Rates; Washtenaw County Health Department District
Residents 1989-2015 (2017). Washtenaw County Health Department Health Department Health
Statistics Tables. Retrieved from
https://www.mdch.state.mi.us/osr/chi/CRI/CriticalInd/Crilhd.asp?TableType=All%20Causes&C
oName=Washtenaw%20County%20Health%20Department&CoCode=48

16. Leading Causes of Death By Age, Washtenaw County Health Department, Michigan 2015.
Washtenaw County Health Department Health Department Health Statistics Tables.
https://www.mdch.state.mi.us/osr/chi/Deaths/31DP/MiniDPObject.asp?AreaCode=48&AreaTyp
e=L&JS=No&SES=P&CI=N&Stat=A

17. Poirier, P., Giles, T. D., Bray, G. A., Hong, Y., Stern, J. S., Pi-Sunyer, F. X., Eckel, R. H.
(2006). Obesity and Cardiovascular Disease: Pathophysiology, Evaluation, and Effect of Weight
Loss. American Heart Association, 113: 898-918.

18. Washtenaw County Community Health Data (2015). Washtenaw County Health
Improvement Plan Survey. Retrieved from https://healthsurveys.ewashtenaw.org/#/survey

19. Prevalence Estimates for Risk Factors and Health Indicators by Race-Ethnicity (2015).
Michigan Behavioral Risk Factor Survey. Retrieved from
http://www.michigan.gov/documents/mdhhs/2015_MiBRFS_Race_Tables_FINAL_540220_7.p
df

20. Infant Deaths, Live Births and Infant Death Rates Washtenaw County Health Department
District Residents, 1989-2015. Washtenaw County Health Department Health Department
Health Statistics Tables. Retrieved from
https://www.mdch.state.mi.us/osr/chi/InDx/Trends/LHDs/trd48.html

21. Summary of 2015 Infant Death Statistics (2017). State of Michigan. Retrieved from
https://www.mdch.state.mi.us/osr/InDxMain/Infsum05.asp

22. Reynolds, M. R. (2015). Maternal overweight and obesity in early pregnancy are associated
with an increase in infant mortality risk. Journal of Evidence Based Medicine. 20 (2) 74.

23. Preventing Chronic Disease and Promoting Health in Michigan: How Well are We Doing as
a State? (2017). Michigan Department of Health and Human Services. Retrieved from
http://www.michigan.gov/mdhhs/0,5885,7-339-73970_2944_67827---,00.html