Social Trends Health Outcomes
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1 Social Trends Health Outcomes Minnesota Council on Foundations Health Briefing May 10, 2011 Paul Mattessich, Ph.D. Wilder Research
2 Minnesota Compass Working to change the equation From: Good intentions + No common base of information = Inefficient decisions To: Good intentions + Sound, credible information + Common sense of purpose = Productive decisions for a strong state &communities
3 Funders Blue Cross and Blue Shield of Minnesota Foundation Blandin Foundation Bush Foundation Greater Twin Cities United Way Initiative Foundation Northland Foundation Northwest Minnesota Foundation The McKnight Foundation The Minneapolis Foundation The Saint Paul Foundation 3M Foundation Wells Fargo Foundation Southern Minnesota Initiative Foundation Southwest Initiative Foundation West Central Initiative Amherst H. Wilder Foundation
4 Topic areas & Co-conveners Aging Dawn Simonson, Metropolitan Area Agency on Aging Children & Youth Chris Ganzlin, McKnight Foundation Civic Engagement Sean Kershaw, Citizens League Disparities Sandra L. Vargas, Minneapolis Foundation Early Childhood Barbara Yates, Minnesota Early Learning Foundation Economy and Workforce Michael Gorman, Split Rock Partners Education Commissioner Alice Seagren, Minnesota Department of Education Environment Steve Morse, Minnesota Environmental Partnership Health Mary Brainerd, HealthPartners Housing Commissioner Timothy Marx, Minnesota Housing Finance Agency Immigration Bill Blazar, Minnesota Chamber of Commerce Public Safety Tom Johnson, Council on Crime and Justice Transportation Robert Johns, Center for Transportation Studies
5 Three Big Trends Growth of the suburban population Aging Increasing diversity
6 Total population and growth forecast: Minnesota Retrieved from MN Compass: Demographics> Population
7 Growth of the suburban population
8 Suburban growth Retrieved from MN Compass: Demographics> Population
9 Population growth by county Growth from Rochester to St. Cloud Retrieved from MN Compass: Demographics > Population
10 Aging
11 Between 2010 and 2030, the number of residents age 65+ in our region is expected to: A. Decrease by one-third B. Stay about the same C. Increase by one-third D. Double
12 Baby Boomers will swell the ranks of retirees Retrieved from MN Compass: Demographics > Age
13 Dependency ratio is changing in the Twin Cities 2010 Retirement age (65+) 2030 Workforce-age (18-64)
14 Implications of aging Positive more people: Living longer Living healthier Contributing to society Employment Wealth Volunteering Negative more people: With chronic health conditions Requiring care Straining the support system (health, financial)
15 We are becoming more diverse
16 Population of Color has tripled in the Twin Cities over the past 20 years Retrieved from MN Compass: Demographics > Race
17 Overall, 1 in 5 people in the Twin Cities is a person of color Greatest/Depression Generations (65+) Baby Boom (45-64) Ratio 1:13 1:8 Gen X (30-44) 1:4 Millennial (15-29) 1:4 Digital (0-14) 1:3-200, , , ,000 1,000,000 Of Color White (non-hispanic)
18 Immigrant population in Twin Cities has grown nearly 40% in this decade alone Mexican immigrants: Somali immigrants: 57% increase 72% increase Retrieved from MN Compass: Immigration > Population Trends
19 Immigrants made up a far higher proportion of the state s population in the past Retrieved from MN Compass: Immigration > Population Trends
20 The Twin Cities immigrant population is different than that of the U.S. as a whole Twin Cities U.S. From Wilder Research A New Age of Immigrants (2010; Minneapolis Foundation)
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22 Why look at Social determinants? Programs and policies Health factors Health outcomes Physical environment 10% Social and economic factors 40% Clinical care 20% Health behaviors 30% What usually gets talked about Source: University of Wisconsin Population Health Institute
23 Why look at Social determinants? Programs and policies Health factors Health outcomes Physical environment 10% Social and economic factors 40% Clinical care 20% Health behaviors 30% What we are talking about today Source: University of Wisconsin Population Health Institute
24 Health inequities are a national issue Estimated life expectancy in the United States Born 1950 Born 1980 Born 2004 Blacks Whites Source: National Center for Health Statistics (2006)
25 Health inequities have been found in other parts of the country
26 Do health inequities exist here in the Twin Cities? If so, what do they look like? And, knowing that, what can be done about them?
27 Fortunately, there are NO health inequities in the Twin Cities
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31 UNFortunately, there are NOTABLE health inequities in the Twin Cities
32 The high quality of life in the Twin Cities is not shared by all Retrieved from MN Compass: Demographics > Poverty
33 Disparities start early and persist Retrieved from MN Compass: Education > 3 rd Grade Reading Scores
34 Education Big gaps exist as young as 3rd grade by racial ethnic group Retrieved from MN Compass: Education > 3 rd Grade Reading Scores
35 Education Big gaps exist as young as 3rd grade by race Retrieved from MN Compass: Education > 3 rd grade reading scores
36 Graduation: Trending upward for most groups Retrieved from MN Compass: Education > High School Graduation
37 Who is not graduating (yet)? (2009)
38 Graduation: Less than half of students of color graduate in four years Retrieved from MN Compass: Education> High School Graduation
39
40 Research context
41 Causes of good health are complex, tricky to disentangle
42 Evidence linking neighborhoods and health has been growing Peer-reviewed articles, Source: B. Entwisle, 2007
43 Neighborhood-level factors linked to health Empirical studies by neighborhood focus Source: B. Entwisle, 2007
44 Report findings
45 Life expectancy by race and ethnicity, Twin Cities 7-county region, American Indian 61.5 African American 74.4 ALL 80.6 White 81.0 Asian 83.0 Source: MN Department of Health (analysis by Wilder Research)
46 Age-standardized deaths per 100,000, Ages 25-64, American Indian 814 Mortality rates by race and ethnicity, Twin Cities 7-county region Black, U.S.-born Southeast Asian, foreign-born ALL White, non-hispanic Black, foreign-born 225 Hispanic 213 Source: MN Department of Health (analysis by Wilder Research) Asian, other 132
47 MEDIAN INCOME Hennepin County Anoka County Ramsey County Washington County You are here By ZIP code, 2000 Carver County Scott County Dakota County
48 Is this a map of Race? RACE Educational attainment? Population Life expectancy? of color by ZIP code, 2000 Poverty? Is this
49 Is this a map of Race? POVERTY Educational attainment? Life expectancy? By ZIP code, 2000 Poverty?
50 Is this a map of LIFE Race? EXPECTANCY Educational attainment? By Life ZIP expectancy? code, Poverty?
51 EDUCATIONAL Is this a map of ATTAINMENT Race? Percent Educational of adults attainment? with at least a bachelor s Life expectancy? degree by ZIP code, 2000 Poverty?
52 Median income Life expectancy
53 Life expectancy increases with area s median household income <$35,000 $35,000- $44,999 $45,000- $59,999 $60,000- $74,999 $75,000+ Note: Life expectancy by ZIP code , Median income by ZIP code, 2000
54 Poverty Life expectancy
55 Life expectancy is higher in areas where poverty rate is lower Highest poverty (20% +) Higher poverty ( %) Middle poverty (4-9.99%) Lower poverty (2-3.99%) Lowest poverty ( %) February 2011 Note: Life expectancy by ZIP code , Poverty rate by ZIP code, 2000
56 When it comes to health in the Twin Cities Race and ethnicity matter but not always in the way you might guess Income matters both yours and that of your neighbors Education matters especially yours, but also your neighbors Place matters all of the above reinforce each other in local contexts Policy matters not just government policy, and not just health policy
57 Racial disparities Retrieved from MN Compass: Disparities > Race
58 Obesity is on the rise Retrieved from MN Compass: Health > Obesity
59 Obesity is on the rise Related to other chronic illnesses Lowers productivity at work Retrieved from MN Compass: Health > Obesity
60 U.S. ranks 2 nd of 33 countries: overweight / obese population
61
62 Reducing the concentration of poverty in Twin Cities neighborhoods could strongly impact children s economic mobility, leading to a lifetime of better health. Tom Fulton President Family Housing Fund
63 Draw upon the experience and knowledge of community members and strategically support these groups in leading interventions that target gaps in conventional health planning. Atum Azzahir President and Executive Director Cultural Wellness Center
64 I would challenge Minnesota to envision a new kind of leadership body comprised of various foundations and firms, hospitals and health plans, nonprofits and neighborhoods, to work together around the common goal of making Minnesota s community environments the healthiest in the country. David Wallinga Director Institute for Agriculture and Trade Policy
65 It is essential that future strategies and solutions acknowledge American Indian people as an asset to the Twin Cities region and work to dismantle poverty dependency strategies that impede effective community building work. Justin Kii Huenemann Founding President and CEO Native American Community Development Institute
66 Community Recommendations (Institute of Health) 1. Build the capacity of community members and organizations. What should be done? 2. Instill health and safety considerations into land use and planning decisions. 3. Improve safety and accessibility of public transportation, walking, and bicycling. 4. Enhance opportunities for physical activity. 5. Enhance availability of healthy products and reduce exposure to unhealthy products in underserved communities. 6. Support healthy food systems and the health and well-being of farmers and farm workers. 7. Increase housing quality, affordability, stability, and proximity to resources. 8. Improve air, water, and soil quality. 9. Prevent violence using a public health framework. 10. Provide arts and culture opportunities in the community. Source: Prevention Institute (2009), A Time of Opportunity: Local Solutions to Reduce Inequities in Health and Safety. Commissioned by the Institute of Medicine Roundtable on Health Disparities.
67 Minnesota Compass: Stay in Touch 1. Sign up for our monthly e-newsletter at mncompass.org 2. Send us reports for the Library 3. Submit your Ideas at Work 4. Connect on the Compass Facebook.com site 5. Subscribe to RSS feeds 6. Follow us on Twitter
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