Dr. Ed Ehlinger challenged state health care leaders this week to stop "admiring the problem" of health inequity — the troubling gap between the excellent health of Minnesota's white majority and the poor health of minorities.
It's easier said than done. The problems are well-defined. Minnesota's low infant mortality rate is belied by the largest gap in the nation between the death rate for white infants (4.4 deaths per 1,000 live births) and for black infants (9 per 1,000). Obesity and related diseases such as diabetes are more common among minorities in Minnesota, as are sexually transmitted diseases and poorly treated cases of asthma.
But the solutions go beyond medical treatment and health insurance coverage. Everything from affordable housing to education to workplace leave policies and fresh produce can influence a person's well-being — so addressing gaps in health means addressing gaps in those areas as well.
Getting the healthy white majority to care sufficiently about inequities will take work. In a system that has been described as "structural racism," the healthy people might be sympathetic, but also loathe to give up advantages that have ensured their superior health.
Ehlinger, commissioner of the Minnesota Department of Health, said he is out to "change the narrative" that the affluent will suffer if more money and resources are redistributed toward improving the health of the poor and of minorities.
Research shows the wealthy actually benefit from the improved health of their entire communities, Ehlinger said. "In the societies with the biggest disparities, the people at the top are not as healthy," he said at a Health Department forum Monday.
One incentive to promote health equity: Businesses select locations based in part on the health of the local workforce. As Minnesota becomes more diverse, key occupations feature more minority workers as well, Ehlinger said.
"We are affected by who serves our food, who takes care of people in the hospital, people in the nursing homes, people in our child care centers," he said. "They are increasingly people of color and people with lower incomes. Their health is going to have a direct impact on the health of the people they are working with."