January 20, 2016 Neighborhood House Planning Committee: Tikki - - PowerPoint PPT Presentation

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January 20, 2016 Neighborhood House Planning Committee: Tikki - - PowerPoint PPT Presentation

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January 20, 2016 Neighborhood House Planning Committee: Tikki Brown- Department of Human Services/ Office of Economic Opportunities Sue Letourneau- Blue Cross Blue Shield/Center for Prevention MN Amy Lopez- Greater Twin Cities United Way

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January 20, 2016 Neighborhood House

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Planning Committee:

Tikki Brown- Department of Human Services/ Office of Economic Opportunities Sue Letourneau- Blue Cross Blue Shield/Center for Prevention MN Amy Lopez- Greater Twin Cities United Way Donna McDuffie- Minnesota Department of Health Aimee Pappenfus- Allina Health Joe Newhouse- Matter Patty Wilder- Minnesota Hunger Initiative

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INCREASED UNDERSTANDING OF:

  • the impact of access to healthy food on healthy

equity.

  • creating a culture of health in Minnesota.
  • local promising practices to improve health

equity.

  • how to increase engagement and investments

in health equity initiatives.

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I. WELCOME II. HEALTH EQUITY IN MINNESOTA Melanie Ferris, Wilder Research Center Allison Liuzza, Minnesota Compass III. KEYNOTE SPEAKER: CREATING A CULTURE OF HEALTH

  • Dr. Dwayne Proctor, Robert Wood Johnson Foundation

IV. TAKING ACTION IN MINNESOTA Commissioner Ehlinger, Minnesota Department of Health Q & A Session: Commissioner Ehlinger & Dr. Proctor V. PROMISING PRACTICES SHOWCASE VI. CALL TO ACTION Assistant Commissioner Anne Barry Minnesota Department of Human Services

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Melanie Ferris, MPH Wilder Research Center Allison Liuzzi, MPH Minnesota Compass

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Wilder Research

Food access and health equity

Demographic trends and efforts underway Wilder Research January 20, 2016

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Wilder Research

How are Minnesota demographics changing?

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www.mncompass.org

We are getting older.

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2014 2014

35 counties

where at least 1 in 5 residents are age 65+

@MNCompass

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2020 2020

61 counties

where at least 1 in 5 residents are age 65+

@MNCompass

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2030 2030

87 counties

where at least 1 in 5 residents are age 65+

@MNCompass

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We are getting more

racially and ethnically diverse.

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For every 100 residents in Minnesota,

18 18

are persons of color.

@MNCompass

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Population of Color is growing faster here than in the U.S.

Population of Color more than tripled in Minnesota

38% 18%

@MNCompass

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Asian and Black populations TRIPLED Hispanic population QUINTUPLED

Growth among all populations of Color, but especially among…

@MNCompass

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Asian

population by county, 2014

@MNCompass

Ramsey 14%

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Black

population by county, 2014

@MNCompass

Hennepin 13%

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American Indian

population by county, 2014

@MNCompass

Mahnomen 42%

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Hispanic

population by county, 2014

@MNCompass

Nobles 26%

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Minnesota’s high quality of life

does not extend to all residents.

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Minnesota is home to one of the lowest poverty rates in the nation, but…

@MNCompass

12% 8% 26% 16% 11% 23%

All residents White (non-Hispanic) Of Color

Individuals below the poverty level

Minnesota and U.S., 2014 Minnesota U.S.

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One in three Black and American Indian residents live below poverty 32% 12%

@MNCompass

38%

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Individuals below poverty

by county, 2014

@MNCompass

Mahnomen 20% Koochiching 15%

  • St. Louis

15% Wadena 16% 18% Todd Winona 16%

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Wilder Research

Why do these changes matter to health?

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Life expectancies at birth, by census tract (2005-09)

Anoka County Ramsey County Scott County Dakota County Carver County Hennepin County Washington County

There are pervasive health inequities in Minnesota

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Health outcomes tend to be worse for residents who live in poorer neighborhoods

Life expectancy by poverty rate group of census tracts Twin Cities 7-county metro (2005-09)

76.5 81.8 82.4 83.1

20.0% or higher 10.0% - 19.9% 4.0% - 9.9% 2.0% - 3.9% Less than 2.0%

79.3 Average life expectancy 81.0

Percentage of households living below poverty

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Structural racism is a leading factor contributing to health inequities

Median household income groups of census tracts

200 400 600 800 1,000

Less than $35000 $35,000- $44,999 $45,000- $59,999 $60,000- $74,999 $75,000

  • r higher

White (Non-Hispanic) African American American Indian Asian Hispanic (All Races)

Age-adjusted mortality rates per 100,000 residents (adults age 25-65)

Sources: Minnesota Department of Health mortality data (2005-2009), American Community Survey (2005-2009)

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  • Infant deaths for African American and American

Indian babies are twice the rate of white babies

  • Obesity rates are highest among American Indian,

Hispanic/Latino, and African American youth

  • 9th grade students who receive free/reduced-price

lunch are less likely to report their health as “very good” or “excellent”

  • On multiple measures of health, outcomes are

poorer for residents in rural Minnesota counties

Racial and socioeconomic inequities impact health for residents of all ages

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Social determinants of health

What contributes to these inequities?

www.mncompass.org

Programs and policies Health factors Health

  • utcomes

Physical environment

10% 10%

Social and economic factors

40% 40%

Clinical care

20% 20%

Health behaviors

30% 30%

Source: University of Wisconsin Population Health Institute

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Health inequities are avoidable differences in health between groups of people that result form systematic differences and social conditions and processes that determine health. Health inequities are avoidable, unjust, and therefore actionable. Health equity is achieved when every person has the opportunity to realize their health potential – the highest level of health possible for that person – without limits imposed by structural inequities.

Health inequities are unjust and avoidable

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  • Structural inequities: Decisions that benefit one

population at the expense of others

  • Structural racism: The normalization of an array
  • f dynamics – historical, cultural, institutional,

and interpersonal – that routinely advantage white people while producing cumulative and chronic adverse outcomes for people of color and American Indians

Source: Minnesota Department of Health

Structural racism contributes to inequities

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Wilder Research

What does it mean to improve food access using a health equity lens?

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  • Impacts 25,000 Minnesotans (~10% of households)
  • Often, occasional and episodic
  • Tends to be more common in households:

– With lower annual household incomes – With children – Headed by a single parent – Headed by a Black or Hispanic adult – Located in rural (non-metropolitan) areas

Food insecurity in Minnesota

Source: United States Department of Agriculture, 2014

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  • The number of SNAP-eligible has increased

– 281,674 in 2006  554,940 in 2013

  • 395,552 eligible for SNAP* in 2014

– 41% children – 21% adults age 60+

  • 66% eligible for SNAP are enrolled, an increase

from 46% in 2008

Supplemental Nutrition Assistance Program (SNAP)

Source: Minnesota Department of Human Services, 2015 * SNAP-only (excluding MFIP-eligible)

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  • Expanded utilization of SNAP by:

– Better outreach to SNAP-eligible households – Increased acceptance of SNAP benefit at farmer’s markets; incentive programs – Expansion of SNAP eligibility requirements

  • Food pantries at schools, health care clinics
  • State policies that increase affordable housing
  • ptions, livable wage jobs, affordable childcare
  • ptions, post-high school education options

Examples of efforts to reduce food insecurity

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26.3 39.1 34.3 8.5 24.2 46.5 42.5 4.1

5 10 15 20 25 30 35 40 45 50 100% fruit juice fruit vegetables fast food Percent

Percent consuming each type of food one or more times per day in last 7 days, by income: grades 5, 8, 9 and 11

Low-income Middle-upper income

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  • Improved quality of food available at food shelves
  • Changes to city park and recreation/school lunch,

vending, sponsorship policies

  • Changes to convenience store inventory
  • Location of grocery stores, farmers markets

– City zoning decisions, co-located grocery stores – Local farmers markets, Twin Cities Mobile Market

Examples of efforts to improve food access

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  • What information does your organization need to

initiate discussion and encourage action to advance health equity? Is there a common language and shared vision within the

  • rganization?
  • In your community, what are the systems in

place that impact food access? Who benefits? Who is negatively impacted?

Questions to ask

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  • How are impacted populations involved in

shaping actions to improve food access and advance equity?

  • Who are your partners? How can you foster

cross-sector collaboration?

Questions to ask

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  • Dr. Dwayne Proctor

Senior Adviser to the President/Director, Health Equity Portfolio Robert Wood Johnson Foundation

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Building a Culture of Health in America

  • Dr. Dwayne Proctor

The Robert Wood Johnson Foundation @drdwayneproctor

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OUTCOME IMPROVED POPULATION HEALTH, WELL- BEING, AND EQUITY

CULTURE OF HEALTH ACTION FRAMEWORK

ACTION AREA 3 CREATING HEALTHIER, MORE EQUITABLE COMMUNITIES ACTION AREA 4 STRENGTHENING INTEGRATION OF HEALTH SERVICES AND SYSTEMS ACTION AREA 1 MAKING HEALTH A SHARED VALUE ACTION AREA 2 FOSTERING CROSS-SECTOR COLLABORATION TO IMPROVE WELL-BEING

EQUITY EQUITY

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A future in which everyone in America has the realistic hope and ample opportunity for the healthiest life possible remains a bold and audacious dream.

Examples of RWJF Equity Principles

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Commissioner Dr. Edward Ehlinger Minnesota Department of Health

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1)What excites you about creating a culture of health in Minnesota? 2)What barriers are there to create a culture of health in Minnesota?

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Q & A Commissioner Ehlinger

  • Dr. Proctor
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Healthy Food Access in Community- Room 212

  • Leech Lake Tribal College
  • Healthy Duluth Area Coalition
  • Minnesota Hunger Initiative, Solutran, Medica, Extension

Service, six participating food shelves Healthy Food Access and HealthCare- Room 272

  • Lakeview Health Foundation, Valley Outreach, The Food

Group

  • Hennepin County Medical Center, Second Harvest

Heartland

  • Matter, American Diabetes Association, Hennepin County

Medical Center Diabetes Education

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  • #1: Funders, join the Minnesota Food

Funder’s Network mcf.org

  • #2: Hunger advocates, join a task force of the

Minnesota Hunger Initiative. mnhungerinitiative.org

  • #3: Leaders, integrate concepts of equity,

healthy food access, and a culture of health into your work.

  • #4: Actively support the Minnesota Food
  • Charter. mnfoodcharter.org