Last year MinnPost interviewed Dr. Brooke Cunningham as she was entering her role leading the state’s newly founded Health Equity Bureau.
The bureau was created so that the Minnesota Department of Health (MDH) could take a better look at the many conditions in people’s environments that affect their health — and create concrete plans to address them. In January, Gov. Tim Walz appointed her as commissioner of the Minnesota Department of Health.
Cunningham spoke with MinnPost to see what the health equity bureau accomplished in the past year — and what’s to come from the Department of Health with her as commissioner. The interview has been edited for length and clarity.
MinnPost: It’s been almost a year since the start of the Health Equity Bureau. In that time, what have you been working on?
Brooke Cunningham: I came on in March 2022, and part of the first thing that I did in those months was get oriented to our COVID equity response. The main thing that I worked on in those first few months was thinking about our COVID data, revamping our equity report, and really getting additional metrics in that report, including looking at cases, hospitalizations and ICU admissions … A lot of my work was regarding COVID, including looking at how our vaccination and testing sites, really looking at the data in a very granular way, and how they were reaching people of color.
And then, of course, as you hit into the summer, the focus of the bureau had to be on budget proposals for the coming session. We are really happy with the way that not only the Walz administration but also the agency internalized internally and prioritized health equity in considering the budget proposals.
MP: What did you find about the vaccination efforts? Were you surprised by the report results?
BC: There’s a lot of opportunity, particularly within Minnesotans of color, to really close gaps in vaccination, which is why we put a lot of effort into our community COVID coordinators and our diverse media vendors. We’re really in a new phase of COVID. It’s been less severe this winter than the previous two years. But we want to make sure we continue to show up for the communities disproportionately impacted by COVID. So we are continuing those efforts that we did throughout the pandemic with that targeted outreach and those community partnerships really to reach individuals most impacted.
MP: Back in April, you mentioned that you planned to meet with various community groups to hear about the problems they were facing. What groups did you meet with and what was top of mind for many of them?
BC: Most of those meetings came through our COVID community coordinators. That program really focuses on Minnesotans disproportionately impacted by health disparities, so people of color, Indigenous Minnesotans, LGBTQ+ Minnesotans and people living with disabilities.
I’ve had a lot of time to talk to folk. The one thing that comes up, no matter which group I talked to, is one, they want us to continue the community partnerships that we’ve been doing. They really feel like the work that we did with COVID was a turning point in how MDH has worked with community-based organizations in the past. People also want to see themselves in the data. MDH is known for its excellence in collecting and analyzing data. People want to improve that by really looking at disability status and data, looking at disaggregating race by ethnicity and making sure we have categories for sexual orientation and gender identity. Those are key things that I’m hearing.
MP: How does MDH interact with policy? What power does MDH have in making policy change? For example, last year, you talked about the need to address circumstances like environmental pollution or poor access to transportation.
BC: As we enter a new phase of the COVID pandemic where we are under perhaps less stress because we’ve got the road map and we’ve got people immunized, so we can start asking those questions again; (like) how do we show up with data that is actionable through a policy space? As we think about social determinants of health and how we (are) an agency with a relatively broad scope, but many of the social determinants are not our primary circle of control. We have to figure out how we can influence those. I believe that how we influence those is by being a resource to our state agency partners and to community organizations by beginning to do some more concrete policy analysis.
MP: How has the Health Equity Bureau addressed social determinants of health?
BC: We are working with community-based organizations to make sure that MDH is a better partner and to make sure that we contribute to the capacity building of those community-based organizations. When we look at our budget proposals, it’s not about focusing on a particular social determinant of health. We have a couple of offices, like the Office of American Indian Health and a budget proposal for the Office of African American Health.
There is one budget proposal about telehealth in libraries, which I would anticipate would most impact rural health disparities in greater Minnesota, where there’s a broadband digital divide.
MP: What are some things you didn’t get around to but want to see happen?
BC: There’s traction we made in terms of the budget proposals that we’ve put forth, in terms of me being in communication with many of our community partners and hearing their needs, in terms of me having some very frank conversations internally with our divisions helping them think about their health equity strategies.
MP: There are countless health disparities in Minnesota. How do you stay hopeful? Are there any organizations or efforts that bring you hope?
BC: As I’ve reflected on my time and my shift from academia into a public health job as assistant commissioner and now commissioner, sometimes in my previous role in academia, I felt a bit isolated. I am never isolated in this work. So that is what gives me hope: when I talk to people, whether they’re MDH staff or people from partnerships community organizations or legislators. It’s the people that give me hope. I know many of us are trying to identify and align and change the state of health for Minnesota such that we reduce inequity. That’s what gives me hope.