Planning-grade DALY framework · Severe opioid crisis, aging rural population, MUA designation · 2026
Disability-Adjusted Life Years · Michigan LE 78.6 · ranked by burden
Interactive — use LE standard and MH prevalence toggles above to recalculate.
Abbreviations: DALY = disability-adjusted life year · YLL = years of life lost · YLD = years lived with disability · MH = mental health · SUD = substance use · CVD = cardiovascular disease · COPD = chronic obstructive pulmonary disease · DM = type-2 diabetes
Expected cases with both conditions simultaneously · independence model · Clare County n=30,013 · hover cell for DW product & DALY correction
DM+COPD highest pair (385 expected co-occurring cases). Independence-model planning estimate (prevalence × prevalence × adult population), consistent with the Isabella methodology. Largest DALY-correction pairs: COPD+Cancer (−11.1), COPD+SUD (−10.8), COPD+MH (−10.1).
Abbreviations: MH = mental health · SUD = substance use · CVD = cardiovascular disease · COPD = chronic obstructive pulmonary disease · DM = type-2 diabetes · DW = disability weight · DALY = disability-adjusted life year
% of population · CDC PLACES 2024 + ACS 2022
Annual productivity loss · DALYs × $62K GDP per capita (human-capital method)
Cancer (~$85M/yr) and the opioid/SUD crisis (~$77M/yr) dominate Clare's measurable economic burden. Each averted DALY ≈ $62,000 recovered — the ROI basis for SAMHSA/HRSA grant budgets. Reactive to the toggles above.
Abbreviations: MH = mental health · SUD = substance use · CVD = cardiovascular disease · COPD = chronic obstructive pulmonary disease · DM = type-2 diabetes · DALY = disability-adjusted life year
Michigan LE 78.6 yrs · No discounting (WHO standard) · Population 30,013
| Condition | Prevalence | Prevalent Cases | Deaths/yr (est.) | Mean Age at Death | YLL | DW | YLD | DALYs | Data Source |
|---|
Mortality derived from Michigan CDC WONDER 2020–22 rates × rural high-mortality adjustment (+15–20%). Prevalence from CDC PLACES 2024 model-based estimates (FIPS 26035). SUD prevalence is a derived estimate — no direct county-level survey. * MH YLD uses active disease prevalence (14.1% = 28.1% × 0.50 remission factor) when remission-adjusted mode is selected.
Opioid overdose death rate estimated at ~47/100k — among the highest in Michigan. Approximately 14 opioid deaths/year in a population of 30,013. SUD kills at a mean age of 44 (34.6 years of remaining life lost per death). Clare County's opioid crisis is structural: high poverty, older workforce, limited MAT access, and MUA designation all compound risk. Neonatal abstinence syndrome rates are elevated statewide in rural Michigan counties.
Clare County's median age is 46.8 years versus Michigan's ~40 — one of the oldest counties in the state. This demographic drives the #1 ranking for cardiovascular disease (710 DALYs, MI LE) and #2 for cancer (1,372 DALYs). CVD accounts for 82.8 estimated deaths/year. An older, rural population also means higher COPD burden (12.7% prevalence vs. MI ~8.2%) and greater disability years relative to mortality.
CDC PLACES 2024 reports 28.1% lifetime-diagnosed mental health prevalence — well above state and national averages. With remission adjustment (×0.50 active burden = 14.1%), MH contributes ~611 YLD. Clare is MUA-designated with severe mental health provider shortages. The intersection of SUD + mental health comorbidity (dual diagnosis) creates disproportionate burden in this population.
16.8% poverty rate by ACS 2022 (estimated 22–25% by MDHHS sources). Median household income of $42,100 versus Michigan's ~$63,000. Physical inactivity at 30.4%, obesity 40.5%, smoking 19.5%. These SDOH are structural drivers of every health condition in the DALY model. Medicaid-heavy payer mix reduces hospital margins and limits specialist access, further compounding the access gap.
COPD prevalence of 12.7% is well above Michigan average (~8.2%). This reflects the county's high smoking rates (19.5%), older population, and occupational/environmental exposures. COPD contributes 868 DALYs (MI LE) — the 4th largest driver. Smoking cessation and pulmonary rehabilitation are high-ROI interventions in this population.
Diabetes prevalence of 15.4% (vs MI ~11%) and hypertension at 35.4% signal a severe chronic disease cluster. Both are amplified by obesity (40.5%), physical inactivity (30.4%), and limited preventive care access. Diabetes contributes 351 DALYs and is a multiplicative risk factor for CVD, stroke, and COPD mortality.
Prioritized by DALY impact and Clare County context · Clare-specific MUA/HPSA designations qualify for additional federal funding streams
SUD · ~14 opioid deaths/year · mean age 44 · 34.6 life-years lost per death · Buprenorphine + naltrexone via telehealth addresses geographic access barriers
CVD · 82.8 deaths/year · 35.4% hypertension · Older population amplifies benefit · Community health worker hypertension control + remote monitoring
Cancer · 60.5 deaths/year at mean age 67 · Rural travel barriers reduce screening rates · Stage-shift = highest mortality impact per dollar in rural settings
MH + SUD · 28.1% MH prevalence · Collaborative care model (IMPACT) + SUD co-management · Addresses dual diagnosis burden at point of care
COPD · 12.7% prevalence · 19.5% smoking · Michigan Tobacco Quitline + NRT through Medicaid · Telehealth pulmonary rehab for rural access