Opinion: Even before COVID-19, Detroiters were dying before their time

Ronald S. Taylor and Herbert C. Smitherman, Jr.

Black America is facing a crisis within a crisis within a crisis: a global pandemic superimposed on a chronic disease epidemic, superimposed on a baseline of chronic and historically based social, economic, and racial injustice. For an already vulnerable senior population, this pandemic is like pouring gasoline on a raging fire.

Between 1990 and 2000, the Detroit area lost 23% of its adult population ages 60 and older due to premature death. This rate of loss, independent of COVID-19, continues today. The Detroit Area Agency on Aging (DAAA) recently released “Dying Before Their Time” (DBTT), the third installment in a 19-year study, conducted between 1999 and 2017, that examines why adults, ages 50 and older, are dying at much higher rates in Detroit and eight surrounding suburbs compared to the rest of the State of Michigan.

Analyzing why this rapid decline was happening was the primary purpose of the first DBTT study completed in 2003. The initial thought was that out-migration was the cause — seniors were simply moving from Detroit to the suburbs.

Detroit's seniors are dying before their time, the authors write.

The report, commissioned by the Detroit Area Agency on Aging and conducted by a team of Wayne State University School of Medicine Public Health Scientists, uncovered alarming results. The 2003 study revealed that over 33% of the older adult population loss in Detroit was due to premature deaths: seniors were dying before their time.

The 2020 study concludes that the death rates of Detroit seniors remain 2-to-2.5 times higher than their counterparts throughout the rest of the state for the past 19 years and pre-pandemic. Despite years of further validating research and advocacy for greater investment in jobs, education, safe housing, increased access to quality health care and social and human services resources — socio-economic factors that account for up to 70% of a person’s overall health status — while there have been community efforts to address these factors, there has been no systemic change.

The report also found that the death rate for Detroit adults ages 50-59 is 122% higher than in the rest of Michigan, and 48% higher for adults ages 60-74. Now, account for the COVID-19 pandemic and the disproportionate rate at which African Americans in Detroit are dying further establishes this public health crisis as an abject lesson in racial and class inequality. These inequalities are founded in systemic, historically based racial, social, health and economic inequities, driven by public policies that must be reengineered to reverse these disturbing trends.

In the communities we serve, these inequalities are a direct correlation with disproportionate numbers of African Americans reaching age 60 with chronic illnesses that will shorten their lives. This is not the future we want for our children and grandchildren.

In the current “Dying Before Their Time” report, the DAAA proposes six specific actions to address this excessive mortality rate in the short term that focus on services and advocacy. Over the long term, the report lays out four broad-based, systemic and institutional policy changes, addressing the many social factors known to influence the health and well-being of an individual and their community.

Our collective goal must be to advocate for all people throughout the lifespan, better prevent and manage onset of chronic disease, and eliminate the risks for premature death. It starts with enhancing health care from birth through every stage of life. It continues as we value the quality of life for all people, reducing isolation and promoting physical, mental, and social engagement, and continuing to make quality health care equitable and accessible. It works when we commit to the creation of age-friendly communities that foster independence where people of all ages can thrive.

We need to intervene now, or we will continue to see the same negative trend line documented in the DBTT study persist over many decades to come.

Ronald S. Taylor is President and CEO of Detroit Area Agency on Aging, one of 16 in Michigan, and serving the largest population of minorities in the state. 

Dr. Herbert C. Smitherman, Jr., is a physician and Vice Dean of Diversity and Community Affairs at Wayne State University School of Medicine and Research Lead on the Dying Before Their Time (DBTT) study. 

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