Race to the bottom: Minnesota's health care gap

Here's one of those Minnesota ironies highlighting yet another gap in our community: While Minnesota ranks among the best in overall health quality, we have one of the nation's largest health quality gaps by race. This is a critical issue state policymakers and key stakeholders must address when formulating Minnesota’s Health Insurance Exchange, which the Affordable Care Act requires be passed by January 2013.

As those following the Affordable Care Act will attest, we’ve already begun to see positive impacts of the ACA in Minnesota. And the Health Insurance Exchange Advisory Task Force—a Governor-appointed, 17-member conglomerate of health care providers, payers, legislators, nonprofit directors, and other key stakeholders—represents a positive method of improving how the state’s health care system serves all Minnesotans, including checking corporate interests by limiting medical companies’ control over the process.

Minnesota can pride itself on this progress, on boasting America’s Health Rankings' "Healthiest State" honor 11 times since 1990, and on the Health Care Exchange Advisory Task Forces' recent confrontation of Minnesota's worst white elephants: The facts of having both the worst achievement gap in the county, and one of the highest rates of racial disparity within its health care system, particularly among its inner-city poor.

How does this manifest?

According to the Minnesota Department of Health's most recent "Immunizations and Health Disparities" report:

• On average, African American citizens live shorter lives and have poorer health outcomes when compared with white counterparts, which reflects the national trend.
• American Indian death rates are two and a half to three and a half times higher than death rates for Whites for most age groups.
• Death rates for African Americans are more than one and a half times higher than Whites in most age groups.
• African American infants display disproportionately higher low-birth-weights and infant mortality rates than other racial groups.
• Women of color were two to three times as likely to receive no prenatal care or inadequate prenatal care, compared with only 2.3% of white women who received inadequate or no care.
• The Hispanic teen birth rate is nearly three times the white teen birth rate.

The inequalities extend vastly beyond these illustrations, and we should congratulate the Health Insurance Exchange Task Force's movement to deal with them as a stride in the right direction. As Minnesota becomes an increasingly diverse land of hundreds of cultures, policy-makers and activists must fight to ensure that initiatives combating these disparities preserve their funding this session, that the upcoming insurance exchange focuses on increasing minorities’ access and awareness around health care options, and that racial parity and cultural responsive solutions are prioritized under the new health care system.