February 3, 2014
MDH legislative report highlights Minnesota’s health inequities
The Minnesota Department of Health has released a legislative report calling for the state to directly address health inequities so that all Minnesotans have the opportunity to be healthy regardless of race, place or income.
The report, Advancing Health Equity in Minnesota: Report to the Legislature (PDF: 130 pages/2053KB), notes that Minnesota’s generally positive health rankings hide some of the nation’s worst health inequities. For example, African-American babies are two to three times as likely as white babies to die in their first year. That disparity is among the worst in the country for U.S. born African American mothers.
"This report highlights that we must focus on making Minnesota a healthy place for all of the adults and children living in the state regardless of factors such as their race, their financial security or where they live," said Minnesota Commissioner of Health Dr. Ed Ehlinger.
The report was requested by the Minnesota Legislature and was grounded in an extensive community process. While drafting this report, conversations were held with over 1,000 participants from more than 180 organizations. MDH received more than 200 pages of online feedback.
To address the problem, the report by the Minnesota Department of Health is recommending increased statewide reporting and collection of data related to health equity, advancing health promotion in all of Minnesota’s policies, increased hiring of people with expertise working with communities of color and American Indians, and increased engagement with communities of color and American Indians.
A key insight of the report is that since health inequities are caused by broad set of societal factors, a comprehensive solution is needed that goes beyond just targeted grants or increased access to the health care system. "Stark inequalities persist in some parts of our society - even after factoring in individual choices," Ehlinger said. "So to address these inequities, we need to include the issue of addressing health disparities as part of a broad spectrum of public investments in housing, transportation, education, economic opportunity and criminal justice."
The report also deliberately decided to "open with race" as a strategy for meeting the challenges of health inequities. It found that Minnesota’s health inequities - differences between the health status of one group and another that cannot be explained by bio-genetic factors - are significant and persistent. These health disparities in part have resulted from structural racism, which refers to racism that is built into systems and policies, but does not necessarily stem from individual prejudice.
The department acknowledges in the report that some of its own decisions have contributed to structural inequities, including the department's habit of working with well-established organizations over groups with ties to other cultures. The report calls for MDH to examine structural inequities in all department decisions and policies moving forward, and to encourage other state agencies to follow suit.
In addition, the report calls for MDH to create a Minnesota Center for Health Equity that will work to institute the report’s recommendations. MDH is already in the process of setting up such a center. The report also recommends that MDH should adjust its grant-making process to allow groups most qualified to work in communities of color to obtain funding. It also calls for MDH to recruit and retain staff with skills related to cultural competence and health equity expertise.
The report also recommends that the health department more closely engage diverse communities when developing health policy and that data should be disaggregated into more racial, ethnic and linguistic groups to more accurately reveal what is happening.
"As we submit this report, we look forward to engaging with Minnesota’s lawmakers during the upcoming Legislative session," Ehlinger said. "It is clear that for Minnesota to have the brightest future possible, we need to eliminate these health disparities, especially those experienced by people of color and American Indians."