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Who gets to live the longest in the Twin Cities and why?

White women in Hennepin County have a life expectancy that exceeds black women by more than three years.
REUTERS/Michaela Rehle
White women in Hennepin County have a life expectancy that exceeds black women by more than three years.

The life expectancy for white men in Hennepin County is more than four years higher than than for black men. White women in Hennepin County have a life expectancy that exceeds black women by more than three years. The gap in Ramsey County is one year larger for men and the same for women.

These disparities were highlighted in the data I used to create a map of life expectancy data for each Minnesota county. Only Hennepin and Ramsey had data for the life expectancy of black Minnesotans, and from that data I found my way to "The Unequal Distribution of Health in the Twin Cities," a recent report by the Wilder Foundation.


The study went beyond black and white and found that life expectancies in the Twin Cities swung from from "highs of 83 years for Asians and 81 years for whites, to lows of 74 years for African Americans and only 61 years for American Indians."

Here's a look at mortality rates in the Twin Cities:

Infographic by Wilder Foundation

They drill down even further: American Indians have a mortality rate three and a half times higher than whites, U.S.-born blacks three times higher, and Southeast Asian immigrants nearly one and a half times higher.

However, mortality rates for foreign-born blacks and Hispanics are a bit lower than for whites, and Asians not from Southeast Asia have a mortality rate that is nearly forty-five percent lower than whites.

These numbers may come as a surprise. Here's what the report had to say about them:

Groups with large numbers of immigrants have better health outcomes than would be expected from socioeconomic characteristics alone. For example, Latinos in the Twin Cities have much higher poverty rates than whites (20% compared with 5%), and much lower high school graduation rates (31% on-time rate, compared with 80%), but have somewhat lower mortality rates, even after adjusting for age differences between the two groups. This surprising “immigrant advantage” is well-known by public health researchers, who generally think that new arrivals benefit from a better diet, less sedentary lifestyle, and other health-protective cultural beliefs and ties. Our analysis suggests this to be just as plausible in the Twin Cities as elsewhere in the United States. Unfortunately, our analysis also highlights that the relatively dire social and economic conditions faced by African Americans born in the U.S. and American Indians in our region are reflected in significantly shorter life expectancies for these groups.

One quite stunning finding in the report is this: "On average, every $10,000 increase in an area's median income appears to buy its residents another year of life."

In a state where the median household income for white families beats that of black families two to one, this is a grim and deeply troubling finding.

What is to be done? Perhaps a better question is what is being done.

At the Metropolitan Council, where efforts are largely focused on projects and planning for the population we have now, the life expectancy issue doesn't come up explicitly. However, says Met Council research manager Libby Starling, connections between health and urban planning are being made all the time now.

"Traditionally the Council focused on physical planning. Today, some of the language the Council uses around what we call 'livable community' programs addresses health — walkability, for example."

At the Minneapolis Department of Health and Family Support, Commissioner Gretchen Musicant can remember the moment the city started talking about health disparities as something to be addressed holistically by many agencies, not just hers.

In 2008, PBS aired "Unnatural Causes," a seven-part documentary series investigating racial and socioeconomic inequalities in health. The morning after each episode aired, Musicant gathered for coffee with a cadre of Minneapolis agency heads to discuss issues raised and what each agency could do to help study and fix health inequality in the city.

Next Musicant worked with the City Coordinator's office to make maps showing all manner of inequality in the city, down to the neighborhood level. For the first time socioeconomic and health data could be layered and hot spots for any number of indicators could be identified.

They found concentrations of issues in places like North Minneapolis, the Phillips neighborhood, and Powderhorn. Today these are places where many of the city's public health initiatives are focused. Efforts that get well beyond "just passing out a brochure," she emphasizes.

Here is a look at a few selected health indicators and the disparities between the white population and people of color in the Twin Cities:

Infographic by Wilder Foundation

There are unexpected uses for the multilayer data first imagined by Musicant as a public health tool. When a tornado spun through North Minneapolis, the city was able to lay their poverty data over a map of the tornado's path to tell a story to the federal government that went beyond just the physical devastation.

"We've really only just begun the conversation across sectors," says Musicant, describing what is emerging from those conversations as "the great big picture."

Here's a short and striking clip from Unnatural Causes:

In public discourse about gaps and disparities in our cities, talk about education or wealth gaps often seems to overshadow health issues. In their book, "The Health of Nations: Why inequality is harmful to your health," Harvard professors Ichiro Kawachi and Bruce Kennedy wrote that "the lackluster performance of our national health indicators ought to be the occasion for national soul-searching." They wrote that in 2006. What we got instead was tussles about "death panels" and the horrors of "socialized medicine."

Soul-searching alone is hardly an adequate response. What efforts have you been a part of in the Twin Cities or in Greater Minnesota to address these issues of health and wealth?

Feel free to plug your work in the comments. Or maybe you've seen or read about or conceived of some innovative approach to health inequality. I want to hear from you too.

Think there should be further investigation of the topic here at MinnPost? I'm taking story suggestions here.

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Comments (6)

Thanks for another really interesting article using facts not readily available to everyone to help us all understand our communities. Smart decisions come from the intelligent use of data.

I'd agree with the previous comment. But I would like to know why you didn't mention that American Indians have a higher death rate than even Blacks.

One wonders why foreign born Blacks have rates lower than Whites. I would imagine it is that the preponderance of them are yet very young. Maybe they should have been excluded from the tables.

That probably would apply to Hispanics, too. And I would like to see an analysis of the Asian numbers.

In England, PM Cameron is instituting Tea Party-like cuts across the board in every area of social spending. The National Health Service is in chaos. Deep cuts to in-home care, housing assistance and every other effort to ameliorate the harmful-to-health effects of poverty will soon make that country resemble the place it was when Dickens wrote his novels.

In both England and the U.S., we'll see the same results from the same kind of cuts-only ideology if the anti-deficit Right succeeds in selling its deficit reduction plan: increased deaths among the poor who no longer receive the help they must have from government to live in dignity. Or, sometimes, at all, especially if they can't afford health insurance.

Thank you! I would like to read similar comparisons of birth rates and infant mortality rates.

A fine piece, Jeff, and further proof that “them that has, gets.”

@ Ray Marshall in #2: based on what I’ve read elsewhere, a significant factor in the lower death rates of foreign-born ethnic populations compared to native-born populations of the same ethnic group seems to be diet. Most foreign-born populations do not have a lifetime of consuming the high-fat, high-carbohydrate diet that’s typical in this country. You may be correct about youth being a factor, as well, but diet plays a significant role, and I’d guess that the same parameters apply to Hispanic and Asian populations, as well.

As for Indians, they’re the poorest ethnic group in the country, which goes a long way toward explaining the fact that their death rate is even higher than that for blacks. They have less access to health care, a poorer diet, are less educated, etc.

It also still helps to be born into a family that lived a long time.