CITY OF MINNEAPOLIS Equity, Health, and Community Connections Gretchen Musicant, Minneapolis Commissioner of Health Joy Marsh Stephens, Equity & Inclusion Manager, City of Minneapolis Sara Chute, International Health Coordinator, Refugee and International Health on behalf of ThaoMee Xiong, Center for Health Equity Director, Minnesota Department of Health April 2, 2016 1
Agenda 1. Welcome Gretchen Musicant 2. Advancing Health Equity Sara Chute 3. Equity and the Minneapolis Comprehensive Plan Joy Marsh Stephens 4. Group discussions - All 2
Minneapolis Health Department Vision: Healthy lives, health equity, and healthy environments are the foundation of a vibrant Minneapolis now and into the future. 3
Determinants of population health Access to care Quality of care Health care, 20% Health behaviors, 30% Tobacco use Diet & exercise Alcohol use Unsafe sex Education Employment Income Family & social support Community safety Socio-economic factors, 40% Physical environment, 10% Air quality Water quality Transit Housing SOURCE: University of Wisconsin Population Health Institute
Highest concentrations of people of color and poverty People of color Poverty Note: Darker shading indicates areas common to both maps, areas with the highest concentrations of both people of color and poverty SOURCE: 2010 US Census 5
Premature death 6
Comprehensive Plan Update April 2, 2016 Community Connections Conference
THE COMPREHENSIVE PLAN Provides long range policy guidance for the City Legally required by state statute & Metropolitan Council regulation Must be updated every 10 years Must be in compliance with regional policy plans Transportation Water Parks Housing
CIVIC ENGAGEMENT GOALS The Process is: MEANINGFUL RELEVANT ACCESSIBLE INCLUSIVE EQUITABLE The Community is: REPRESENTED INFORMED Meaningful and relevant dialogue Inclusive representation Access to information & opportunities An empowering experience Contributions are heard & have impact Effective use of resources HEARD EMPOWERED
ADVANCING HEALTH EQUITY Sara Chute, MPP International Health Coordinator, Refugee and International Health On behalf of ThaoMee Xiong, Center for Health Equity Director Minnesota Department of Health
Public Health Public health is what we, as a society, do collectively to assure the conditions in which (all) people can be healthy. Institute of Medicine (1988), Future of Public Health
Prerequisite conditions for health Peace Shelter Education Food Income Stable eco-system Sustainable resources Social justice and equity World Health Organization. Ottawa charter for health promotion. International Conference on Health Promotion: The Move Towards a New Public Health, November 17-21, 1986 Ottawa, Ontario, Canada, 1986. Accessed July 12, 2002 at <http://www.who.int/hpr/archive/docs/ottawa.html>. 12
Terminology Health Equity: Achieving the conditions in which all people have the opportunity to attain their highest possible level of health. Health Inequity: A health disparity base in inequitable, socially-determined circumstances. Health Disparity: A population-based difference in health outcomes.
Structural Racism v.s. Institutional Racism Structural Racism: the normalization of an array of dynamics - historical, cultural, institutional, and interpersonal that routinely advantage white people while producing cumulative and chronic adverse outcomes for people of color and American Indians. Institutional Racism: Institutional racism refers to the policies and practices within and across institutions that, intentionally or not, produce outcomes that chronically favor, or put a racial group at a disadvantage.
Triple Aim of Health Equity-Essential Practices Implement a Health in All Policies Approach with Health Equity as the Goal Expand the Understanding of What Creates Health Social Connectedness Strengthen the Capacity of Communities to Create Their Own Healthy Futures
White Paper: Income and Health Life expectancy by median household income group of ZIP codes, Twin Cities 1998-2002 50.0 Adults 18-64 reporting "fair" or "poor" health status by income, Minnesota 2011 40.0 90.0 70.0 Life expecanty in Years 74.1 77.3 79.6 80.7 82.5 Percent 30.0 20.0 10.0 26.8 14.9 10.0 6.4 3.1 11.7 50.0 Less than $35,000 $35,000 to $44,999 $45,000 to $59,999 $60,000 to $74,999 $75,000 or more 0.0 Less $20,000 $20 to $34,999 $35 to $49,999 $50 to $79,999 $75,000 or more DK - refused Source: The unequal distribution of health in the Twin Cities, Wilder Research www.wilderresearch.org Analyses were conducted by Wilder Research using 1998-2002 mortality data from the Minnesota Department of Health and data from the U.S. Census Bureau (population, median household income, and poverty rate by ZIP code Source: 2011 Behavioral Risk Factor Surveillance System
Those with lowest incomes least likely to have access to paid sick leave--mn 90 80 Access to paid sick time for full-time workers in MN by annual income 70 60 Percent eligible 50 40 30 20 10 0 <$15 $15-<$35 $35-<$65 $65+
Predictors of Health by Race The connection between systemic disadvantage and health inequities by race is clear and predictive of the future health of our community
Mortality Disparity Ratios by Race/Ethnicity and Age in Minnesota, 2007 2011 4 3.7 3.3 3 2.5 2.1 2 1.8 1.7 1.6 1.8 1 1.2 1.3 0.9 1.0 0.6 0.8 0.8 0.7 0.8 1.0 0.6 0.4 0 1-14 years 15-24 years 25-44 years 45-64 years 65 years and older Black or African American American Indian Asian Hispanic* White * Hispanic may be any race.
How did we get here? Why should we care? Disparities are not simply because of lack of access to health care or to poor individual choices. Disparities are mostly the result of policy decisions that systematically disadvantage some populations over others. Especially, LGBTQ, low income people, and rural communities, and populations of color and American Indians
Thank You! For more information or questions, please contact: Ms. ThaoMee Xiong, Director Center for Health Equity ThaoMee.Xiong@state.mn.us 651.201.4086
MISSION STATEMENT Minneapolis 2040: An inspiring city growing in equity, health, & opportunity.
COMPREHENSIVE PLAN VALUES
EQUITY ONE MINNEAPOLIS
EQUITY LENS How will this policy or initiative impact Native Americans and communities of color? How have we involved community members and stakeholders in understanding these impacts and identifying solutions? What does the data and stakeholder conversations tell us about existing racial inequities that we should consider? Is there an opportunity to reduce disparities? What is the root cause creating these racial inequities?
EQUITY BIG IDEAS
Facilitated Discussion Part A: Envisioning Equity in Minneapolis: Write one phrase to describe what we want Minneapolis to look like in 2040 Part B: What are actions we need to take to get there?
Highlights from discussion
Thanks! Gretchen.Musicant@minneapolismn.gov ThaoMee.Xiong@state.mn.us Joy.Stephens@minneapolismn.gov www.minneapolismn.gov www.health.state.mn.us