- Where do African-American and American Indian infants die at twice the rate of white infants in their first year of life?
- Where are African-American and Latina women more likely to be diagnosed with later-stage breast cancer?
- Where are poverty rates for children two times higher for Asians, three times higher for Latinos, four times as high for American Indians, and almost five times as high for African-Americans than for white children?
The disturbing answer is Minnesota. Even though Minnesota is one of the healthiest states in the U.S., we have some of the widest gaps in well-being between white residents and people of color in the nation.
The Minnesota Department of Health documents these disparities in its report to the Legislature, Advancing Health Equity in Minnesota. The report challenges us to understand health equity in a more comprehensive way, emphasizing that “Health is something we create as a society and as communities, not something an individual can purchase or produce alone.” The report should prompt policymakers to think more broadly about how all Minnesotans have the opportunity to lead healthy lives.
Ensuring Minnesotans of all backgrounds can lead healthy lives will take more than increasing access to better health care. According to the report, only 10 percent of health outcomes (like infant mortality or cancer) can be explained by clinical care – but 40 percent is determined by social and economic factors, such as job opportunities, transportation options and the quality of schools. Without the right conditions in place, it is difficult for people to achieve their highest possible levels of health. According to the Department of Health report, health equity is dependent on all Minnesotans having:
- Access to economic, educational and political opportunity.
- The capacity to make decisions and effect change for themselves, their families and their communities.
- Social and environmental safety in the places they live, learn, work, worship and play.
- Culturally competent and appropriate health care.
Understanding, for example, the role housing, transportation and education play in contributing to good health is integral to Minnesota truly tackling the challenge of racial health inequalities in our state. That is why the study urges all legislative committees, not just the health and human services committee, to study and act on the findings of this valuable report. For example:
- Transportation policy can build or disrupt neighborhoods, and influence access to school, jobs and recreation. Transportation decisions also affect the quality of the environment – high traffic congestion can reduce air quality for the neighborhoods surrounding major roads.
- Education is an important predictor of health outcomes, and it is related to a child’s future earning potential. Education policy that removes gaps in opportunity for students helps them succeed in school and live healthy lives. Research has shown that when students feel connected to their school, they do better academically and are less likely to engage in risky behaviors that could harm their health. However, the Minnesota Department of Education has found that school misconduct policies can disproportionately negatively impact children of color. This contributes to less educational success, leading to a lifetime of negative health effects.
- Safe and stable housing is just as important for health as having enough food. Discrimination in the housing market has led to lower rates of home ownership and higher rates of foreclosures among communities of color, making it more difficult for these Minnesotans to maintain safe and stable housing.
Minnesota can make real progress toward positive health for all when social, economic and environmental policies work well together.