The Unequal Distribution of Health in the Twin Cities

Blue Cross Foundation and Wilder Research report reveals shocking statistics

ST. PAUL, Minn., Oct. 7 /PRNewswire-USNewswire/ -- A report released today by the Blue Cross and Blue Shield of Minnesota Foundation and Wilder Research finds that health and life expectancy are strongly connected to median area income, neighborhood conditions, education and race.

"Minnesota leads the nation in terms of consistently ranking as one of the healthiest states," said Patrick Geraghty, board chair of the Blue Cross Foundation and president and CEO of Blue Cross and Blue Shield of Minnesota. "Yet we can have up to a 22-year gap in how long people can expect to live, due to factors often beyond their individual control. At the Blue Cross Foundation, we believe that all Minnesotans should have the opportunity to live a long, healthy life, regardless of their income, education or ethnic background. That's why we commissioned this report — to document where there are gaps."

The study analyzed health data, organized by ZIP code, to determine the impact of several socioeconomic factors on health.

The findings include:

• An increase of $10,000 in an area's median income (not individual income), is associated with a full year gain in life expectancy.
• Life expectancy varies greatly by race in the Twin Cities, ranging from a high of 83 years for Asians to a low of 61.5 years for American Indians. Overall life expectancy is 80.6 years.
• Children born into the highest income/lowest poverty areas can expect to live 8 years longer than those born into the lowest income/highest poverty areas.

The study also revealed that median area income affects residents' health at every level in the Twin Cities. People who live in middle income areas can expect to live longer than those in low-income areas, but not as long as those in more affluent neighborhoods. Another finding was that education pays in terms of health. Life expectancy is nearly five years less for people who live in areas where fewer than 12 percent held a bachelor's degree than those living in neighborhoods where more than 40 percent are college graduates.

"These findings support research going on in other areas of the country that confirms that a person's health is strongly influenced — as much as 50 percent or more — by social determinants, such as income, education and neighborhood conditions," said Craig Helmstetter, consulting scientist with Wilder Research.

The research also showed that the Twin Cities experiences the "healthy immigrant paradox," as do other areas of the country with significant immigrant populations. Although income and educational attainment are often lower, immigrants experience better health than residents who have lived here more than a generation.

"Obesity and diabetes rates were found to be lower for Latino and Asian immigrants. They were also lower for African-born blacks than for U.S.-born blacks," said Helmstetter. "We should learn from the health-promoting cultural practices of new arrivals, including strong supportive relationships, beliefs and cultural practices."

Recommendations for a healthier Minnesota

The report authors invited responses from eight community leaders who offer recommendations for action to reduce health inequities in the Twin Cities and all of Minnesota, including:

• Those working to reduce poverty, close educational gaps, eliminate segregation and create high-paying jobs can use the report to broaden their case to include the tangible economics of improved health.
• Medical practitioners should lend their voices to efforts to improve conditions that affect the health and longevity of their patients and the community at large.

"Private interests have long had financial stakes in products or practices which, intentionally or not, have served to make our community environments less than healthy," said David Wallinga, M.D., director, Food and Health Program for the Institute for Agriculture and Trade Policy in Minneapolis. "Moving forward, I would challenge Minnesota to envision a new kind of leadership body. This new entity, comprised of various foundations and firms, hospitals and health plans, non-profits and neighborhoods, would bring all of them together around the common goal of making Minnesota's community environments the healthiest in the country."

"We can make choices about what kind of economy we have," said Nan Madden, Minnesota Budget Project director. "Those choices should take into account that economic prosperity in our region depends on all Twin Cities residents having the chance to reach their fullest potential in education and employment. Policy choices that help reduce income and employment disparities ensure that all people in our region have access to opportunities for education and a good job."

Blue Cross takes action to reduce health disparities

Acting with the knowledge that health is directly tied to social determinants such as race, education, income and neighborhood, Blue Cross supports programs including:

• Preventing Harm Minnesota with the Native American Community Clinic — Funding supports an effort to pass city codes for mandatory inspections of rental housing and increase renters' awareness of their rights to improve health in the Phillips neighborhood, Minneapolis.
• 500 Under 5 — Funding supports efforts to improve school readiness for 500 young children in the Folwell and Near North neighborhoods in Minneapolis, leading to improved life-long health.
• East Side Neighborhood Development Corporation — Funds are used to educate St. Paul homeowners, renters and child care providers on how to create healthier, safer and more sustainable living environments. The project also connects residents with home repair and improvement programs, and helps families replace lead-painted windows with non-toxic, energy-efficient windows.
• Wilder Foundation — Blue Cross Foundation funds support a project to improve the mental health and social adjustment of Southeast Asian immigrants and refugees in the Payne/Phalen area of St. Paul. Funds have also supported the development of Minnesota Compass, which tracks and analyzes data on many social influences on health statewide.
• Community Giving Garden — Blue Cross employees tend a community giving garden on the company's Eagan campus that provides hundreds of pounds of fresh produce annually to Lewis House, a Dakota County shelter for victims of domestic violence, and the Eagan food shelf.
• Healthy Eating: Healthy Corner Stores Intervention — The Minneapolis-based Institute for Agriculture and Trade Policy (IATP) is funded to work with corner stores in selected underserved areas of Minneapolis to increase fresh produce offerings, thereby helping eradicate the city's "food deserts" (areas lacking healthy food options).
• Healthy Eating: Market Bucks Program — Blue Cross matches funds received by low-income families, giving them more money to buy fresh food at local farmers markets.
• Healthy Eating: NorthPoint Health & Wellness — Funding is helping increase residents' access to fresh produce through community gardens and other efforts.

Tobacco Control: Comunidades Latinas Unidas en Servicio (CLUES) and Statewide Tobacco Education and Engagement Project (STEEP) — Two Blue Cross-funded efforts to establish tobacco-free policies in apartments in the Latino community and promote culturally appropriate tobacco cessation strategies and collaborate on health and wellness efforts in the Southeast Asian community.  "The disparities revealed in this report are unjust and avoidable," said Geraghty. "We must look at health in a broader way and ensure that education policies, housing policies and economic policies are viewed also as health policies so that no matter where you live, you have an equal opportunity to be healthy."

For more information on Blue Cross Foundation efforts to reduce health inequities or to view the full report, visit www.bcbsmnfoundation.org.

The Blue Cross Foundation is the state's largest grantmaking foundation to exclusively dedicate its assets to improving health in Minnesota, awarding more than $28 million since it was established in 1986. The Foundation's purpose is to look beyond health care today for ideas that create healthier communities tomorrow, through a focus on key social, economic and environmental factors that determine health, to improve community health long-term and close the health gap that affects many Minnesotans.

Blue Cross and Blue Shield of Minnesota, with headquarters in the St. Paul suburb of Eagan, was chartered in 1933 as Minnesota's first health plan and continues to carry out its charter mission today as a health company: to promote a wider, more economical and timely availability of health services for the people of Minnesota. Blue Cross is a not-for-profit, taxable organization. Blue Cross and Blue Shield of Minnesota is an independent licensee of the Blue Cross and Blue Shield Association, headquartered in Chicago.

For more than 100 years, the Amherst H. Wilder Foundation has combined direct service, research and community development to address the needs of the most vulnerable people in greater St. Paul. For more information on the Wilder Foundation, visit www.wilder.org.

SOURCE Blue Cross and Blue Shield of Minnesota Foundation