Senators examine health disparities

Near the end of a public, off-site meeting for the Senate Health, Human Services and Housing Committee on Monday night, a public health advocate for the Somali community approached the microphone and recited a number of “very serious concerns” within the immigrant community, which, he said, had been unfairly targeted for investigations of nonprofit health organizations.

After finishing the main points of his argument, the man informed Sen. Kathy Sheran, DFL-Mankato, that he and other activists would continue to bring their case for better health outcomes for minorities to the Capitol, and even to Sheran’s house, if necessary. The committee chair gave a slightly uneasy smile, and thanked the man for his thoughtful, passionate input, before adding that she and all of her fellow members are committed to the cause.

Most testifiers at the Center for Changing Lives, a health and housing facility in south Minneapolis, were appreciative of Sheran for bringing the committee’s work out of the Capitol and into an area of the city where minorities are actually the majority. The hearing was held within the district of Sen. Jeff Hayden, DFL-Minneapolis, one of just two black senators in the state. Hayden, a key DFL figure on health care policy matters, said Minnesota has a “long ways to go” to alleviate the racial disparities in terms of health and housing.

That phrase was supported almost immediately by Jeanne Ayers, assistant commissioner of the Department of Health, who recited a long list of troubling statistics that separate Minnesota’s white and non-white populations. Most stark, according to Ayers, is the fact that Minnesota has the lowest infant mortality rate in America, though a black or Native American baby born in this state is twice as likely to die within its first year as a white one.

According to one study Ayers citied, some $1.2 trillion is lost annually due to the overall fallout of disparities and premature deaths in America, and she blamed “policy decisions that systemically disadvantage some populations” and “structural racism” as the root of the problem.

The racial gap reveals itself across several measurements, said Ayers, pointing to the fact that 75 percent of white Minnesota residents own their homes, compared with 45 percent of Hispanics and just 21 percent of blacks.

Ayers’ presence was partly the result of a 2013 addition to state health care statute, mandating a report that specifically investigates racial disparity and crafts recommendations for improvements. Among the new approaches borne out of that report, Ayers said, are stronger systems to collect and analyze data and a change in the way the department doles out grant funding to nonprofit organizations.

Several speakers represented portions of the state’s immigrant populations, including Kamal Hassan, who said he had moved to this state hearing about “Minnesota nice,” but thinks, when it comes to treatment of foreign-born citizens, the state “could be nicer.” Hassan complained that immigrants are seen only as potential consumers of health care, and not providers, and said public health organizations geared toward serving minorities had been “systematically eliminated … by a cabal between state agencies and [managed care organizations].”

Said Hassan: “Those providers make money out of these poor people, they have homes in nice suburbs … and our people are homeless.”

Another testifier, Charity Tatah Mentan, originally from Cameroon, observed that many immigrants come to the United States already educated, or receive college education here, but still cannot find work in the public health field. Tatah Mentan herself has two degrees and is working toward a Ph.D., but said her only way to contribute to community health is as a volunteer with an HIV and tobacco outreach organization.

“Many of us are already qualified, and could be doing constant communication with community experts, as a liaison,” Tatah Mentan said. “We need to get their information into the system. There is bound to be health equity if we do our homework well.”

Sheran echoed Tatah Mentan’s thinking, saying she had recently attended a meeting in Mankato where five foreign-born residents described being two years removed from receiving higher education degrees, though none had been able to find a job yet.

“I’m concerned that’s reflective of what’s being described here,” Sheran said.

Ora Hokes, a black American activist, talked about the destructive effect of the marketing of menthol cigarettes toward minorities. Hokes credited the Legislature, and Hayden, for finally taking specific steps to curb the rate of menthol use among blacks, but said more could be done, citing a citywide ban in Minneapolis on the sale of “candy” cigarettes, which target children.

Hokes also pushed for more assistance toward prevention or quitting smoking for minorities, suggesting the state could eliminate co-pays on health costs for counseling or safer nicotine-delivery systems.

“There should be no cost barriers, especially when you consider many of these individuals are low-income,” Hokes said.