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Who's healthy, who's not: By race, income, neighborhood in Twin Cities area

A child born into one of the wealthier areas of the Twin Cities — say, certain neighborhoods in Edina or Eagan — will likely live at least eight years longer than a child born into an impoverished, inner-city neighborhood.
 
That finding and others being released today demonstrate disturbing inequities in health among Twin Cities area residents.
 
Good health and longevity, it seems, depend not only on a person's genes but also their zip code, their ethnicity and race and how much schooling they've had, according to a new report prepared by Wilder Research and commissioned by the Blue Cross and Blue Shield of Minnesota Foundation.

Presented this morning in St. Paul, the report, called "The unequal distribution of health in the Twin Cities,'' reveals that here as elsewhere across the nation a person's health is heavily influenced — as much or more than 50 percent — by these social factors: income, education, race and neighborhood.
 
Generally, the unhealthy are non-white and poor, according to the study. [PDF]


The study is rich in statistics but not surprising for the health disparities it uncovers, said Nan Madden, director of the Minnesota Budget Project, who has seen similar racial disparities here with regard to income, education and poverty rates.

Life expectacy by ZIP code
Source: Wilder Research, Blue Cross and Blue Shield of Minnesota Foundation

For those who would ask: "Why are there racial disparities? And are they 'inequities'?" the report writers say this:
 
"…[W]e argue that it is not race itself that causes the disparity, but rather the social and economic disadvantages heavily concentrated within populations of color that cause poorer health outcomes within these groups.''
 
As a group, people of color in the Twin Cities area — except, often, Asian and Latino populations and African immigrants — fare worse than whites on a number of health measures, including birth weights, obesity, diabetes and mortality, according to the study.  
 
For instance, in Hennepin County 39 percent of U.S. born blacks are obese and 12 percent have diabetes. For American Indians, it's 32 percent and 18 percent, whites 19 percent and 5 percent, and Asians 5 percent and 7 percent.
 
Charts and graphs compare and contrast race, ethnicity and health; socioeconomic status and health, and the interaction of socioeconomic status and race on health with data culled from the Minnesota Department of Health, the 2000 U.S. Census, the American Community Survey and other sources.
 
The report also charts leading causes of death in the Twin Cities seven-county region between 2005 and 2007, correlating those with racial and ethnic groups, median household income, poverty and educational achievement.
 
Prepared in cooperation with an advisory group representing more than a dozen health, government, education and other groups, the study characterizes the inequities as unjust and avoidable, while also crediting many in the state who are already working toward helping Minnesotans gain equal opportunity for good health.
 
Among the significant findings in the Twin Cities region from the report, prepared by Craig Helmstetter, Susan Brower and Andi Egbert of Wilder Research, are the following. 
 
Income: "Each additional $10,000 in an area's median household income is associated with a full-year gain in life expectancy,'' with those living in [highest] income areas and lowest poverty rates having an average life expectancy of 82 years, compared to residents in the lowest income areas with an average life expectancy of 74 years. "

Life expectancy based on median income
Source: Wilder Research, Blue Cross and Blue Shield of Minnesota Foundation

Education: Those with the least education have a life-expectancy of almost five years less than those with at least a four-year- college degree.

Lief expectancy by education
Source: Wilder Research, Blue Cross and Blue Shield of Minnesota Foundation

Race: Life expectancy varies from highs of 83 years for Asians and 81 years for whites to lows of 74 for African Americans and 61 for American Indians, with significant health issues more likely affecting the lives of U. S. born African Americans and American Indians.

Mortality rates by race
Source: Wilder Research, Blue Cross and Blue Shield of Minnesota Foundation
Numbers in table above are per 100,000.

Neighborhood: Children born into the highest income areas live eight years longer than those born into the lowest income neighborhoods.
 
Reactions to the findings are peppered throughout a supplement to the report and in accompanying statements, including these.
 
From Dane Smith, of Growth and Justice: "Not just the poor and racial minorities benefit from greater economic security and reduced inequality. Research shows that mortality and longevity rates are superior for all income levels in the more equal states.''
 
Dave Wallinga, a physician with the Institute for Agriculture and Trade Policy, challenges Minnesota to "envision a new kind of leadership body comprised of various foundations and firms, hospitals and health plans, nonprofits and neighborhoods, to work together around the common goal of making Minnesota's community environments the healthiest in the country.''
 
Atum Azzahir of the Cultural Wellness Center, calls for strategic efforts.  "…[E]ffective initiatives and polices will not only have to draw upon the experience and knowledge of community members, but will need to strategically support these groups in leading interventions that target gaps in conventional health planning.''
 
Madden, from the Minnesota Budget Project, says, "The economic future and quality of life in the Twin Cities depend on everyone having access to opportunity. That means quality jobs, a good education and all the things that make for a healthy life."
 
Marsha Shotley, president of the Blue Cross and Blue Shield of Minnesota Foundation, said: "We've learned the truth about health inequities in our area, and our determination for change is renewed. Our hope is that policy makers, community residents, business leaders, educators and all of us who volunteer and vote will speak loudly and help plot a future of growth that includes every Minnesotan.''

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Comments (13)

The distribution of life expectancy and its correlation with race in the cities of Minneapolis and St. Paul should surprise absolutely nobody.

Here's something far more interesting: in the exurbs there's still a large variation. These are places that, to the best of my knowledge, are demographically identical. What's going on there?

As usual, them that has, gets.

Also as usual, culture matters. We're all going to die, but the price for being poor and uneducated is that you will die sooner. Eight years seems a pretty steep price.

So then does it not follow that social security is a huge transfer of wealth from low-income people of color (who die younger) to wealthier white people (who live longer)? Doesn't social security rob low-income people of wealth they could pass on to their children, which the studies implies would make them healthier?

Doesn't this study show that life expectancy has less to do with the health care system and "greedy doctors" and more to do with economic and education status?

Doesn't this study imply we shouldn't be mucking around with a health care system that sustains the lowest-income individuals with the least education to age 74; instead we should be supporting overall economic prosperity to increase longevity?

The point is, this study will be interpreted in a silo. Making it about "equality" means that the well-being of some must be sacrificed for the well-being of others through force of government with the ultimate result less well-being for all.

Question: If they repeat this study in ten years and the range of life expectancy is 90 years at the top to 80 years for low-income/less educated, would that be a bad thing because inequality is greater?

Look, it's all cultural.

The wealthier you are the less likely you are to smoke, eat fast food, drink alcohol to excess, and live in unsafe neighborhhods.

Where's my grant money?

Not a surprise at all. http://www.unnaturalcauses.org/ a good documentary that talks about this very issue.

This study could not be more correct. Not only are the poor less likely to be healthy because their access to ongoing preventive care may not exist, but they are not as likely as the better-off to be educated to a level that would allow them to move into well paying jobs.

Not to mention being able to afford a diet that includes more fresh fruit, vegetables and lean meats.

Some people miss no opportunity to grind their favorites axes, Mr. Westover.

Minnesota's sales tax is almost one full point higher than the employee's social security tax rate of 6.2%. Perhaps the poor would be better off not paying that, especially those without jobs in the first place.

One of the study's implications is that education and money beget better prenatal care, which in turn increases the likelihood of a healthier and longer life. I recommend Time magazine's recent article on that subject: How the first nine months shape the rest of your life.

http://www.time.com/time/health/article/0,8599,2020815,00.html

Craig Westover says:
"So then does it not follow that social security is a huge transfer of wealth from low-income people of color (who die younger) to wealthier white people (who live longer)? Doesn't social security rob low-income people of wealth they could pass on to their children, which the studies implies would make them healthier?"

Now there is a fine piece of logic. Cut the old poor off of social security so they die sooner and they can "pass on to their [ 'wealth' to their] children"

You bet Craig, not me.

or there is always socialism. 81% in Sweden.

http://www.wolframalpha.com/input/?i=swedish+life+expectancy

Westover--
If SSI wasn't set aside there is a likelihood that it would be spent and there is the likelihood that no wealth would be accumulated. Now, yes I can see that you would say that "choosing" not to accumulate wealth is the problem of the individual. Yes, you would be making a very fine libertarian argument. But, SSI was created as a safety net. Everyone pays in as a sort of supplemental insurance.

Your idea of no safety net was tried in the 19th century and it did not work so well. You can argue the constitutionality of everything and the rights of the individual but your point does not lead to a civilized society. There is no denying that over the last thirty years the more more taxes are lowered, the more everything is deregulated or simply unenforced, the greater the divide.

The study doesn't really on greedy doctors, but it does say that there needs to be some innovation in care. That remains to be determined. It's really the libertarian chip on your shoulder that sees anything else in this story--and that pretty much sums up the rest of your argument(s) as well.

These gaps in longevity cost all of us. We pay for the poor health of members of our society, probably far more than if we had a comprehensive health care system that engaged people from pregnancy on up. Don't forget: before these people die, they will be in poor health for years and live miserable lives.
I started taking my health more seriously when I realized I didn't want to be in poor health in the last years--20-30 maybe--of my life. I care about that a lot more than how long I live.
Compassion comes into the picture too. Why would you say as though it's a given that it will be interpreted in a silo? You don't know that. From all I've read these kinds of figures ARE put together with others and give people an opportunity to find answers.
It would be much easier without people trying to purvey nonsensical information about social security and transfers of money. The biggest transfer of $$ started 20-30 years ago and has just grown--in favor of the already rich.

Seriously, this is news to ANYone? If Vegas took odds on study findings before they came out, I'd be a rich man... No, wait... I wouldn't make a dime because everyone would bet the same way I do.

The Social Security "inequality" might have a point if lifetime constant employment at the same way is considered for whites versus certain minority groups but there are other factors to Social Security.

First off, there are survivors benefits, especially for children where one parent dies after accumulating the minimum Social Security payments. This does require marriage before the death. A DNA establishment of parentage of the child by the deceased will suffice.

Social Security disability rates are higher for most minorities, including children than for whites. Finally, there is the Social Security "floor" minimum payments after working even the minimum number of quarters. Ten quarters (or whatever it is) of work, usually at not much the minimum wage with Social Security and Medicare takeouts does not even begin to cover the "floor" SSI payments which tend to be between $600 and $800 per month for an individual. Most people who do this "minimum" do it over age fifty with no "on the books" work history. This group is disproportionately not Caucasian.

Let's conquer this like we've done with public schools: drag down the ones on top to equalize the ones on the bottom. Then everyone feeels good. Go Mark Dayton!