On Health Equity by Commissioner of Health Dr. Ed Ehlinger

Commissioner of Health Dr. Ed EhlingerWhen it comes to good health in our state, not everyone has a level playing field. This has dire consequences for disadvantaged Minnesotans, but there’s a growing awareness that health disparities make it harder for everyone in a community to achieve full health.

At one time, Minnesota was the healthiest state in the nation. In recent years, our ranking has eroded due in large part to increasing disparities in health outcomes across racial, economic and geographic groups. These disparities have emerged for complex reasons, but there is reliable evidence that some of the most important factors are the structural barriers in economics, education, transportation, healthcare, and discrimination facing rural communities, tribal nations, and communities of color.

These health disparities are more than just sociological constructs. They have real consequences – to individuals, families, and our state’s economy. For employers, they mean increased health care costs and reduced worker productivity. For families and individuals, they can mean long-term, serious health conditions such as obesity and diet-related chronic diseases that reduce life expectancy and affect income and well-being. For our economy, it means a greater portion of our available resources must be spent on treating sick people and fewer dollars are available to support education, transportation, economic development and other shared priorities.

To address this serious and growing problem of health disparities, Minnesota’s state government is focusing on how to level this playing field and ensure all Minnesotans have the same opportunity to be healthy. Minnesota Governor Mark Dayton has charged all state agencies with advancing equity and working to put ‘health in all policies.’ No matter what kind of policy, we must consider how it impacts community health and well-being. That’s why at MDH we’re adopting what we call a “health equity lens,” which informs the way we design and implement policies, systems, practices, budgeting, services, and programs. To make it easier to apply this health equity lens to specific programs and policy areas, we’ve developed a concept called the “Triple Aim for Health Equity,” which includes the following:

  • Expand the understanding of what creates health
  • Take a “health in all policies” approach, with health equity as the goal
  • Strengthen the capacity of communities to create their own healthy future

What does this mean in real-life terms? For one thing, it means ensuring that local public health agencies have the resources they need to work with community partners to make it easier for all members of the community to make healthy choices about active living, healthy eating, tobacco use and other factors. It means making investments as a state in building and fostering economic and infrastructure development, housing, transit, healthcare, criminal justice, education, human services, and agriculture ? investments that consider how to promote health and reduce preventable diseases.

Why should local and state leaders bother with all this at a time when there are so many other big problems that need to be addressed? There are a few simple but powerful reasons. First the investments we make today in boosting health equity will pay off handsomely over the long run in the form of reduced health care spending. After all, it is far more expensive to treat a seriously ill person than it is to keep a healthy person healthy. These efforts can also help build a ‘culture of health’ for all Minnesotans. This culture of health will enable everyone in Minnesota to lead healthier lives – today and in the future.

As a state, our commitment to advancing health equity and reducing health disparities will ensure that health is connected to healthcare, but also encompasses:

  • Work, family, and community
  • Access to opportunity and health equity
  • Balancing costs, outcomes, and impact of treatment and prevention, providing Minnesotans with the environment and care of the highest quality, value, and results

In essence, our work to build a culture of health in Minnesota and advance health equity means we’re focusing on the big picture of what it means and what it takes to be and stay healthy. We’ll need to collaborate, innovate, and use the best tools available to accomplish this ambitious effort.

The Minnesota Food Charter is a great example of an ambitious shared roadmap for policy and systems change that seeks to build a culture of health and advance health equity in our state. Thousands of Minnesotans came together to identify the Food Charter’s 99 strategies to reduce barriers that prevent reliable access to safe, affordable, healthy food. Implementing Food Charter strategies are a great way for any organization, agency, or partnership to ensure a legacy of health for our state. The Food Charter’s Health Equity Guide contains tools, strategies, and case studies for partners wanting to undertake effective, equity-focused Food Charter work.

MDH has been a lead supporter for the Food Charter for five years. We understand the integral connection between healthy food and good health. The Food Charter is an important way that we can implement policy and systems changes at local, regional, and state levels that will ensure the health and prosperity of all Minnesota’s communities. We are excited to continue the important partnership in this area.