Michigan

Michigan is the eighth most populous U.S. state, with just over 10 million residents as of 2008. The population is predominantly Caucasian (over 80 percent), including a significant population of Arabic descent in the Grand Rapids area who migrated to the United States early in the 20th century to work in the auto industry. African Americans are the largest minority group and are a majority in Detroit and several other industrial cities. The largest religious group is Roman Catholic.

In 2007, the median household income in Michigan was $47,950, ranking 26th among U.S. states, and average annual pay was 15th highest among states at $43,141. Michigan ranked third highest in home ownership at 76.4 percent. This income was unevenly distributed, however, resulting in extremes of wealth and poverty. In 2007, 14 percent of the population lived below the poverty level (ranking Michigan 17th among U.S. states) and the unemployment rate was 7.2 percent, the highest in the country. Both poverty and unemployment have increased recently, severely in some areas, due to the decline of the auto industry and the subsequent loss of both manufacturing and ancillary jobs. Although Michigan is home to several major research hospitals and universities and ranks in the middle of the states in terms of the supply of doctors (245 per 100,000 population, ranking 25th), access to health care is not evenly distributed; as a result, the state ranks poorly on some major indicators of maternal and child health.

In 2007, Michigan ranked 13th among states on infant mortality with a rate of 7.9 per 1,000 live births. A 2004 Centers for Disease Control and Prevention study of 26 U.S. states found that Michigan mothers ranked poorly on many factors related to prenatal health care, including smoking (31.7 percent, 3rd highest) and alcohol use (57.9 percent, 5th highest). Tobacco use was highly associated with poverty: 53.9 percent of women on Medicaid (government insurance for people with low incomes) reported smoking before pregnant, as did 47.2 percent of women with no insurance, contrasted with 23.0 percent for women with private insurance. Of Michigan mothers surveyed, 12.7 percent reported postpartum depression and 48.1 percent reported that they were on Women, Infants, and Children (WIC).

According to Ipas, an international organization dedicated to protecting women's rights, Michigan ranks nearly last (42nd) among U.S. states in this area. Ipas ranks Michigan poorly because of restrictive abortion laws, including mandatory counseling, waiting period and parental involvement, and for laws restricting family planning services for minors. Ipas also reports major differences in maternal health care by race: for instance, the infant mortality rate for African Americans was almost three times that of Caucasians (17 percent versus 6.1 percent); substantially more Caucasian than African American or Hispanic women received prenatal care beginning in the first trimester (90 percent versus 73 percent and 78 percent, respectively). The teen fertility rate for Caucasians was 26.4 per 1,000 births, versus 67.8 per 1,000 for African Americans and 71.6 for Hispanics.