The term “health equity’’ can make Minnesotans uncomfortable, reminding the white majority of how poorly minorities are faring in an otherwise healthy, wealthy state with a proud tradition of expert medical care.
Take Minnesota Community Measurement’s 2017 health equity report, released this month. It showed that black and American Indian Minnesotans were less likely in 2015 to have good control of diabetes or to receive timely colon cancer screenings than white patients.
But not all of the news was bad. Community Measurement director Jim Chase took heart in the rate of doctors counseling overweight children, particularly minorities. Among American Indian children with body mass indexes in the 85th percentile, 88 percent received counseling on nutrition and exercise. The rate for white and black children was 86 percent.
Increased physician counseling in and of itself might not eliminate health disparities; the 2016 Minnesota Student Survey showed 19 percent of white female ninth-graders to be overweight or obese, compared to 30 percent of black classmates and 37 percent of American Indian classmates.
But over time, it could make a dent in child obesity rates, which could in turn affect adult rates of diabetes and heart disease, Chase said. “Even thought it’s a process measure, it’s one that you would expect to have an impact.”
Some clinic groups performed better than others. Fairview Health provided obesity counseling to only 53 percent of its black pediatric patients last year and 49 percent of American Indian patients. Not that Fairview discriminated — its overall screening rate was 46 percent.
Fairview vice president of quality and innovation Val Overton said the clinic system is working to improve its obesity counseling rate, but also is among the best in the state at providing good and equitable care of diabetes and asthma.
Chase said clinics are under pressure to improve in many areas, so some might be focusing on other measures than obesity counseling.
Publicizing the data is less about assigning blame in an area where Minnesota could do much better, he said, and more about motivating clinics to improve. “It gives them a chance to see how they are doing, and to decide whether they want to prioritize it.”