Age-standardized comparison of Washtenaw (Ann Arbor) and Wayne (Detroit) · with rural counties for context · July 2026
Age-standardized YLL rate (US-2000 standard) removes the age-structure difference between a college town and a large city
| County (city) | Population | DALYs/yr | Age-std YLL /100k | Crude DALY /100k | Leading causes |
|---|---|---|---|---|---|
| Washtenaw (Ann Arbor) | 367,730 | 63,379 | 8,251 | 17,235 | Cancer · CVD · Substance use |
| Wayne (Detroit) | 1,773,082 | 442,251 | 14,177 | 24,943 | CVD · Cancer · Substance use |
On the age-standardized mortality burden, Detroit's rate is about 1.7× Ann Arbor's — the single clearest finding here. Both cities share substance use as the #3 driver, but the lead cause differs: cancer in Ann Arbor, cardiovascular disease in Detroit. Age-standardization matters most for Washtenaw, whose large student population deflates its crude rate.
What the cause mix says about each place
A young, highly educated, well-insured population where chronic disease (cancer, then CVD) dominates and the overall age-standardized burden is the lowest of the analyzed counties.
Heart disease is a third of the burden, with an enormous substance-use component (1,107 deaths/yr). Deaths also strike younger, pushing the age-standardized rate to 1.7× Ann Arbor's.
In both cities substance use is the #3 driver and directly observed. In small rural counties these deaths are statistically suppressed and effectively invisible — a key blind spot the urban data exposes.
Earlier crude-method estimates. Substance-use and mental-health mortality were statistically suppressed and are not included, so these totals are not comparable to the urban counties.
| County | Population | DALYs/yr (crude) | Method |
|---|---|---|---|
| Isabella | 64,565 | 13,493 | v1 crude |
| Midland | 82,884 | 14,335 | v1 crude |
| Clare | 30,013 | 8,198 | v1 crude |
| Gratiot | 41,368 | 7,533 | v1 crude |
A future update can re-run these rural counties on the same age-standardized basis (they would need age-specific population and would still have suppressed substance-use/mental-health cells). Until then, cross-generation ranking is not supported.
Planning-grade estimates — not peer-reviewed research or official GBD county estimates. Urban counties: CDC WONDER 2020–22, CDC PLACES 2024, CDC Single-Race Population Estimates 2020–22, IHME GBD 2021. See each county's methods page. Rural counties use the earlier crude pipeline.