Promoting Good Health is an Upstream Battle

In October, the Wilder Foundation joined forces with Blue Cross and Blue Shield of Minnesota to produce a comprehensive study of health disparities in the MN Metro Area titled: “The Unequal Distribution of Health in the Twin Cities.” The study confirmed what many of us probably suspected — that just like in several other areas of the US, there is a strong correlation between socioeconomic status and health in the Twin Cities.

The study analyzed life expectancy values across factors such as race/ethnicity, location, income, and education and found that:

  • American Indians and US-born African Americans have significantly lower average life expectancies and higher mortality rates than other racial groups
  • Racial groups containing a high percentage of immigrants tend to have lower mortality rates
  • There is an 8 year difference in life expectancy between residents of the highest income/lowest poverty rate zip code and residents of the lowest income/highest poverty rate zip code (and for the statistically minded, there is an almost-perfect linear correlation between median income of an area and life expectancy — approximately 1.5 years for every additional $10,000)
  • Mortality rates of those aged 25-64 in zip codes with <12% college-educated adults are 2 times that of zip codes with >40% college-educated adults
  • Disparities across different zip codes still exist within individual racial groups (in other words, whites living in lower income areas have much higher death rates than whites living in higher income areas, and this trend holds even more significantly for African American and Native American groups)
  • Racial disparities tend to be less pronounced in higher income areas

The most striking finding from this report is that where a person lives can have a significant impact on how long he or she is expected to live. In other words, there are a host of social and economic factors that significantly but indirectly impact the health of people originating from their community and environment. These factors lie upstream of the healthcare system, even prior to what is termed “preventive” health care:

A major motivation behind the creation of the MN College Health Corps was to overcome health disparities that exist across socioeconomic and racial lines in the state, so it has always been a central component of our mission to enact systemic and sustainable positive change in the health landscape of Minnesota. However, the release of this report has motivated us to assess how we can further integrate upstream health interventions into our program.

The CHC has so far been guided by two primary goals: (1) promoting health literacy and (2) providing equitable access to healthcare services. According to the above model both of these interventions fall “downstream,” and though important they alone cannot solve the health problems that our communities face. Therefore, we are adding a third goal: (3) working upstream to increase the capacity of communities to support healthier people.

We are in the process of integrating this goal into our overall program action plan, and hope that this new model will inspire the development of exciting upstream initiatives from our CHC sites!

Post By: Jessica Zha, VISTA Leader

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