Washtenaw County is home to a diverse and growing immigrant population. Immigrants contribute significantly to the county’s economic vitality, cultural richness, and community life. However, recent reports from the Washtenaw County Health Department highlight persistent health disparities that disproportionately affect both immigrant communities and maternal and infant health outcomes.
Two recent reports released by the Washtenaw County Health Department provide critical insights into these challenges and offer guidance on how our systems can respond more effectively.
The Immigrant Health Assessment (2023-2024) and the Maternal and Infant Health Report (2017-2022) examine health outcomes and access across some of the county’s most vulnerable populations. Together, they reveal overlapping barriers and opportunities to improve health outcomes for all populations.
Immigrant Health Assessment Key Findings
Immigrants make up about 12 percent of Washtenaw County’s population, or just over 46,000 people. The largest group by region of origin is from Asia, followed by Europe and Latin America. More than half of the county’s immigrant population has lived in the United States for more than ten years and about half have become naturalized citizens. Despite this long-term residence, many immigrants still face significant obstacles to health care access.
Mental Health challenges were a major theme throughout the report, based on focus group and interview feedback. Immigrants often face mental health issues like carrying the weight of different traumas they’ve endured, such as war-related trauma from their country of origin, generational trauma, and trauma related to resettlement. Immigrants also feel worry over family members who are still living abroad, cultural stigmas, and learning how to access mental health resources.
Access to care remains another major barrier. Many individuals reported difficulty navigating the healthcare system, from understanding what services are covered to knowing where to go and how to apply. These challenges are often compounded by language and literacy barriers. With limited interpreter services and unclear paperwork, many immigrants face long wait times and delays in receiving essential care and services.
Additional concerns include limited access to affordable housing and culturally appropriate food, as well as fear related to further complicating daily life and can directly impact health outcomes.
The report suggests a number of ways local organizations can help reduce these barriers. These include improving language access, hiring multilingual staff, offering cultural sensitivity and trauma-informed care training, and ensuring clear communication around privacy protections and immigration policies. Access to legal aid was also identified as a key need for increasing stability and access to care.
Maternal and Infant Health: Persistent Gaps in Outcomes
The second report focuses on maternal and infant health data collected between 2017 and 2022. It shows several notable trends, particularly during and following the COVID-19 pandemic.
Both the birth rate and fertility rate declined during the pandemic, and the average maternal age has risen slightly in recent years. Teen birth rates, however, have continued to fall and remain significantly below state and national averages. Between 2020 and 2022, women aged 30 to 34 represented the largest share of births in Washtenaw County.
Despite these encouraging trends, disparities in birth outcomes remain significant. The infant mortality rate for Black or African American infants was found to be 3.5 times higher than that of white infants during the 2020 to 2022 period. Low birth weight rates increased slightly during the pandemic, with the highest rates seen among Black or African American infants, younger and older mothers, and individuals insured through Medicaid. These cases were particularly concentrated in communities like Ypsilanti and east Ann Arbor.
While preterm birth rates saw a slight decrease, gestational diabetes has become more common, especially among mothers with private insurance. Smoking during pregnancy declined overall, though it remains more prevalent among Medicaid-covered individuals.
Where These Reports Intersect
Although focused on different populations, both reports point to similar challenges. Many immigrant mothers in Washtenaw County face compounded barriers that affect both their own health and the health of their infants. Language limitations, financial and legal uncertainty, and reduced access to culturally competent care can all contribute to poorer health outcomes.
The stress and isolation associated with the COVID-19 pandemic appear to have amplified these challenges. Disruptions in care and support systems likely played a role in the increase in low birth weight and other risk factors. As both reports suggest, health outcomes are shaped by a complex mix of factors, including race, age, insurance coverage, geography, immigration status, and language fluency.
Turning Data Into Action
The findings in these reports highlight several opportunities to improve health equity across Washtenaw County through coordinated systems-level planning and targeted policy approaches.
Strengthening language access remains a foundational need. Expanding interpreter services and translated materials, and ensuring consistent multilingual communication across public health and social service systems, will help improve access and understanding. Addressing structural barriers to prenatal and postnatal care, such as transportation, scheduling, and affordability, is also essential, especially for families with limited English proficiency or those living in underserved areas.
Legal support is another area where improved coordination could reduce fear and increase access to services. Ensuring that immigrant families understand their rights and available protections can reduce uncertainty and promote better engagement with health systems.
Cross-sector partnerships will be critical to addressing social determinants of health such as food access, housing stability, and transportation. Integrated service models that combine medical care with supportive resources for pregnant and postpartum individuals may offer more effective and sustainable outcomes.
Finally, more robust and disaggregated data collection will help identify where disparities are most severe and which interventions are making an impact. Data on race, ethnicity, language, insurance status, and immigration background can guide future planning, resource distribution, and program development.
Looking Ahead
The reports offer valuable insights into where our systems are working, and where there is room for improvement. By using this data to inform policy, program design, and collaborative planning, partners across Washtenaw County can continue to build a more inclusive health system and community.
The Washtenaw Health Initiative remains committed to supporting this work and helping advance cross-sector solutions that serve all members of our community.
For access to the full reports or to learn more, visit the Washtenaw County Health Department website for further information.