Also, smoking and vaping have increased in both West Michigan and Detroit. The researchers said while traditional cigarette smoking has declined, the rise in vape smoking "produces no notable difference in smoking behavior over time."

Montanera said among health care expenditures for chronic diseases, asthma expenditures are the outlier, rising 26% from 2023 to 2024 for West Michigan residents, according to data from private health plans administered by Blue Cross Blue Shield, Blue Care Network, and Priority Health. By comparison, expenditures for coronary artery disease, depression, diabetes and other chronic conditions rose by 3% or less during the same period.

He added that the rise in asthma-related expenditures could be attributed to changing guidelines in how it is treated, with recommendations for inhaled corticosteroids paired with long-acting beta agonists rather than short-acting beta agonists.

Also, Montanera said the average length of stay in hospital (ALOS) in West Michigan has gone from the lowest among the communities tracked to the second-highest. ALOS has increased from an average of more than 5 days per admission to just under 6.5 days, a 23% increase in two years.

Montanera said the increase can be attributed to managed care organizations, specifically Medicare Advantage programs, being more selective in directing patients to rehabilitation and nursing facilities, while those post-acute facilities are struggling with staffing and capacity to accept patients.

"High ALOS is a problem as it creates additional costs for serving patients who should no longer be in the hospital and they're taking up beds from patients who do need to be there," Montanera said.

More information about the Health Check report is online.