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:
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:
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.