MIAMI DADE COUNTY

The Only County in the U.S. With Immigrant Majority
With an estimated population of 2.37 million (2005), Miami-Dade County is not only the most populous county in the state of Florida but also the eighth largest in the country. Its population exceeds that of the District of Columbia and 17 states (including Alaska, Delaware, Hawaii, Idaho, Maine, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Dakota, Rhode Island, South Dakota, Utah, Vermont, West Virginia, and Wyoming). The County has a relatively young population. The median age in the County is 36.6 years old, comparable with the national average. The estimated percentage of racial and ethnic minorities within the general population in Miami-Dade County was 81.8% in 2005 (U.S. Census Bureau 2005). As mentioned earlier, Latinos comprised 61.12% of the County’s total population.

Miami-Dade County accommodates 1.18 million immigrants, nearly half of whom are naturalized U.S. citizens. The County is one of the traditional “gateway” areas into the U.S. It has been the destination for large numbers of immigrants since the 1960s. Indeed, over the past four decades, net migration into the County has accounted for more than 70% of its population growth (Miami-Dade County, 2003). The percentage of immigrants is exceptionally high in Miami-Dade County (51%), when compared to the country overall (11%) or with other counties. According to the 2004 American Community Survey, Miami-Dade was the only County in the U.S. with an immigrant majority. It had the highest percentage of immigrants, followed by Kings County in New York (43.9%) and Hudson County in New Jersey (39.3%).

Two cities within Miami-Dade County—Hialeah and the city of Miami—were ranked top two in 2000 among large cities with high percentage of immigrant population. In these two cities, 72.1% and 59.5% of the respective population were immigrants. A recent United Nations Development Program report, Cultural Liberty in Today’s Diverse World (2004: 99), noted that the city of Miami has the highest percentage of immigrants of any large city in the world, followed by Toronto (44%) and Los Angeles (41%). Immigrants in Miami-Dade County are almost exclusively from Latin America (97%) (U.S. Census Bureau, 2004). Mexicans, the largest single Latino group in the U.S., however, are not among the top five Latino immigrant groups in the County. Immigrants of Cuban descent are the largest single population group, accounting for 51% of all Latin American immigrants. Cubans are followed by Colombians, Nicaraguans, Hondurans, and Dominicans. Altogether, they make up approximately 70% of Latino immigrants in Miami-Dade County. Partly due to its demographic characteristics, Miami-Dade has a high percentage of residents who have difficulty speaking English. Indeed, the County has the highest percentage of people 5 years of age or older who speak English less than “very well” (34%) in the U.S. (U.S. Census Bureau, 2004). More than one fifth of the population was estimated not to have any health insurance (U.S. Census Bureau 2000).

A County That Houses the Poorest Large City in the U.S.
Miami-Dade County is a land of contrasts. On the one hand, as an immigrant gateway, the County plays an important economic role in the Americas. The arrival of highly skilled immigrants from Cuba in the 1960s helped attract financial institutions and other businesses that trade with Latin America and the Carib-bean (Portes & Stepick, 1994). The County and its surrounding region are now considered as a financial gate-way to Latin America and the Caribbean. The area is home to headquarters of at least 26 major international and domestic corporations (Beacon Council, 2006). Miami has been ranked as the best city for doing business in Latin America by America Economica, a Spanish language business publication (BICUMP, 2004).

On the other hand, Miami-Dade County faces high levels of poverty. 17% of County residents are below the poverty level, much higher than the overall poverty rate of 13% in the U.S. The County ranks among the poorest 10 largest counties in the U.S. Median family income in the County is $40,927, well below the U.S. median family income of $53,692. This figure is even lower in the city of Miami ($26,824), which is located in Miami-Dade County. Indeed, the city of Miami is ranked by the U.S. Census Bureau as the poorest large city in the U.S. Compared with other large counties, the residents of Miami-Dade County also have the highest rent burden in the U.S. Approximately 61% of the renters in the County spend 30% or more of their household in-come on rent and utilities. In comparison, 44% of all renters in the U.S. spend a similar percentage of their in-come on rent (U.S. Census Bureau, 2004). In relative terms, homeownership is also expensive. The County has the second highest mortgage burden of the largest counties, behind Kings County, New York. 54.4% of Miami-Dade’s homeowners with mortgage pay more than 30% of their income on mortgage payments (BICUMP, 2004), compared with the U.S. average of 32.4%.

A Medically Underserved Area
High levels of poverty and the heavy housing burden in Miami-Dade suggest that residents of the County have less ability to fend for the basics for themselves and their families, including food and health (BICUMP, 2004). These problems are exacerbated by problems in delivery of health care services in Miami-Dade County. The County is a designated “health professionals shortage area” (HPSA), with shortages of primary medical care, dental and mental health providers. The County accounts for the largest concentration of MUA/P (Medically Underserved Area/ Population) in the state of Florida, which houses 8.57 million underserved populations (53.64% of its total population) (Figure 4) (FIU 2005). According to the Department of Health and Health Services Administration, 63% of the County’s population (1.417 million) lives in medically underserved areas (MUP), facing serious economic, cultural or linguistic barriers to health care barriers and to obtaining medical care. Of this number, 872,573 (61%) are Latinos.

There is also a scarcity of community-based primary care centers/ programs in areas which accommodate large populations of new immigrants (almost exclusively Latinos) and lower income persons, such as the western and southern sections of Miami-Dade County (Health Council of South Florida, Inc., 2000: 35). Moreover, the quality of care provided in the County is poor. A recent study published in the New England Journal of Medicine on hospital performance ranked twenty-six Miami-region hospitals collectively in the bottom quartile of the 40 largest hospital-referral regions (total of 3,558 hospitals) based on their quality of care scores (Jha, Zonghe, Orav and Epstein, 2005) (...more).