Part IV in a four part series on health outcomes affecting Black Minnesotans. You can read Part I, about breast cancer disparities, here. Part II on sickle cell disease here and Part III on respiratory health here.
Pastor Edrin Williams shows up daily for his congregation of nearly 800 people. He wouldn’t be able do that if he didn’t have ways to take care of himself.
“You’ll never be spiritually healthy while remaining emotionally unhealthy,” Williams said. “I talk openly about the fact that I meet with a therapist on a regular basis.”
Therapy is one way Williams takes care of himself. It’s an important way to maintain health, he said, especially for Black Minnesotans, who have lower life expectancies than their neighbors.
Minnesota ranks high nationally when it comes to life expectancy, coming in with the fourth highest in the nation, according to newly released data from the CDC.
Yet disparities persist in the metro areas. In Hennepin county, Black people live around six years less than their white counterparts and around five years less than their white counterparts in Ramsey county, according to the 2022 County Health Rankings, which used data from 2018-2020.
There are a variety of factors that explain why that gap exists. A 2021 report by the Urban League Twin Cities details how factors like police violence, air quality, income, housing, employment and access to health care can affect life expectancy and a population’s livelihood.
What’s holding the Twin Cities back?
Black Minnesotans have high rates of chronic conditions, said Dr. Kevin Gilliam, a physician at NorthPoint Health and Wellness Center in north Minneapolis.
“We here tend to see a lot of people with hypertension or high blood pressure,” he said. “That’s the number one diagnosis. It’s quite prevalent in the community.”
Disparities in conditions like breast cancer, sickle cell and asthma, as discussed in parts one-three of the Black in Minnesota series, impact quality of life and the number of years people may have left.
Gilliam has worked at NorthPoint for almost 14 years. In that time, he’s observed a need to serve the community that’s not always met. Many times, economic disadvantages are the root cause of the inequities that arise, he said.
In 2021, 28% of the clinic’s population was uninsured. He said having the financial ability for treatment or even getting routine check-ups can change someone’s life expectancy.
“If a person was diagnosed with diabetes … and did not undergo treatment or any intervention at all, and those sugars continued to be poorly controlled without any intervention, they would likely experience the consequences like … heart disease to kidney disease. Multiple things can happen as a result of that, and therefore lead to a shorter life expectancy,” Gilliam said. “Engaging with the health care system when there is something that can be done definitely can aid in increasing life expectancy in many of the diseases that people encounter chronically.”
With asthma, being diagnosed and having interventions can improve other aspects of life, he said.
“People don’t realize they’re not functioning to their fullest ability until we do breathing tests and say ‘Your lungs are not filling up in the way they should. And then we give them medicine, and they say, ‘I didn’t realize I wasn’t breathing as much as I could have been. I feel a whole lot better. My kids are able to play and join in recess and do gym.’ Adults are able to go for walks and exercise when previously they would just stay home and not do much,” Gilliam said.
Life conditions dictate life expectancies
Minnesota’s unhoused populations have high rates of chronic health conditions, with around 81% of unhoused adults having a chronic health condition, a 2020 Wilder Research report found. Minnesota’s unhoused peoples also have a much lower life expectancy. People experiencing homelessness had a death rate three times higher than the general population, according to the newly released Minnesota Homeless Mortality Report. Relative to proportions statewide, Black or American Indian people are overrepresented in the homeless population.
Williams said that stress and systematic oppression can also take a toll on life quality and expectancy.
“We’re mindful of the stress and the strain that comes with being historically oppressed; people who live their lives on the margins, who’ve had to learn to do more with less. That certainly takes a toll on both the body and the mind,” Williams said.
Safety is also a big concern for Black youth, said Diana Hawkins, executive director of the Hawthorne Neighborhood Council.
“The biggest thing right now among our youth is that they’re scared for their life in school, and they’re scared that they’re getting stuck up by other youth that are running around here stealing cars, they have guns; they’re selling drugs. You (have) good youth that are just walking home and they’re getting stuck up,” Hawkins said. “It’s a big impact. These kids are so traumatized now.”
On top of that, she sees stress caused by lack of resources, with the recent closing of Aldi and Walgreens in north Minneapolis.
“That’s impacting the neighborhood with stress right now because people have to go farther. People might need their medicine within 24 hours, and they may not be able to get it. That right there is stress. It’s stress trying to get to the bus stop, and you have to worry about either getting mugged or someone sitting there doing drugs. That’s the stress that I see, and I hear about,” Hawkins said.
Hawkins is a part of the Northside Urban Coalition, which focuses on improving the quality of life and outcomes for Northside youth. The coalition works to curb the impacts of drugs, alcohol, opiates and trauma, primarily through education, she said.
The Blue Zone approach
In 2004, a group of people identified five geographic areas throughout the world where people lived better and longer. They dubbed those places “blue zones,” where people reach age 100 at a rate 10 times higher than in the United States, and they do so with lower rates of chronic disease.
The Blue Zones Project expanded to North America, and in 2009, a program started in Albert Lea, Minnesota.
“It’s really transformed our community in so many ways. First would just be what we call the built environment. Albert Lea has added more than 12 miles of new sidewalks and trails, plus three miles of bike lanes,” said Cathy Malakowsky, the Albert Lea project leader.
Malakowsky said the city’s focus on reducing smoking rates and increasing outdoor public spaces has made a lasting impact.
And the data agrees. From 2014, smoking rates in Albert Lea have declined from 21.2% of all adult residents to 7% in 2021. High cholesterol in the area is down by 13.2% and Albert Lea residents are living longer, with 68.5% of residents “younger” than their chronological age, which is substantially higher than the state rate of around 54%, according to a survey conducted in 2021 by the group.
After just one year of being a “blue zone,” participants added nearly 2.9 years to their average lifespan, according to the organization.
The Blue Zones initiative could be effective in other cities, Malakowsky said. But an investment has to be made, she said.
“It’s expensive to build sidewalks and trails, but when you see tobacco use drop and high cholesterol drop and high blood pressure drop, that means our employers are seeing more productivity, less sick days being used and overall people are just happier,” Malakowsky said.
For many, their religious faith can be a form of managing stress, Williams said.
“My ministry is in many ways a trauma-informed ministry,” said Williams. “I think about the ways in which singing and songs can be healing for people. I think about the ways that mindfulness and prayer and meditation can be healing and restorative for people. I think about the importance of simply having a physical space to go to, feel safe and be with other people who look like you.”
He said he’s created a space to be open about the impacts of years of systematic oppression Black people faced and its effect on people’s mental health.
“(We) have seen our faith as a way to not only survive the experiences of Black people here in America, but also to rise above the challenges and find ways to thrive despite those challenges,” Williams said. “I look at this country or our nation, and I don’t see a clear line of America becoming a less racist place or a less oppressive place. Racial challenges seem to be continuing, and they don’t seem to be going anywhere soon. If society’s not gonna get better, I think the work is on us to be able to grow in resilience and in strength and in all those things that help us to withstand the negative forces that are sent our way day in and day out as Black people in America.”
Williams tries to highlight the importance of addressing mental health to his congregation.
“There’s nothing wrong with having a therapist, and so it goes a long way to have your spiritual leader acknowledged that they too are receiving support around their mental health,” he said. “I don’t know that I could do this work long term if I didn’t have a holistic care plan that included having a therapist that helps me to remain healthy.”
The church refers members to different services like mental health resources at NorthPoint. Those services are on a sliding scale, meaning they are more accessible to lower-income patients or those who are uninsured, Gilliam said.
Increasing programs like that, he thinks, would help increase accessibility and life expectancy.