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Study shows life-and-death inequities

Date Published: 10/17/2010

Author: Dane Smith, President

ST. PAUL LEGAL LEDGER CAPITOL REPORT

For all you potential new humans out there in the ether who are destined to be born in the Twin Cities, here’s a tip for a longer and healthier life: Don’t let that stork drop you in the wrong ZIP code.

Do not be born to parents who are poor and uneducated, black or American Indian, and living in St. Paul’s Frogtown or North Minneapolis, or in the growing pockets of poverty in the inner-ring suburbs. You simply must take personal responsibility and make better choices than that.

You need to get yourself born to white or Asian parents who are affluent and well educated and living in Wayzata or Woodbury. Choosing some combination of the latter could make a difference of as much as two decades in how long you live.

And one more thing: Just remember that once you are born, you are mostly on your own.

Because there’s a growing group of angry people down here who think our society and our government has no business asking for more from those who made the right choices to help you fix your bad choice on this matter.

Apparently, it’s your personal responsibility to be born to the right parents and in the right place, and if this or that charity doesn’t somehow come to your rescue, tough cookies.

This, of course, is pure fancy. We don’t get to communicate with incoming souls and we don’t get to choose the circumstances of our birth.

But this hypothetical conversation is based on a reality, when you consider this troubling new antipathy toward the disadvantaged, and the important research conducted recently by the Blue Cross and Blue Shield of Minnesota Foundation and Wilder Research.

Among the key findings about socioeconomic impacts on health and longevity, citing directly from the headlines in a supplement to that report:

“Income matters: Each additional $10,000 in an area’s median household income is associated with a full year gain in life expectancy.”

“Education matters: Life expectancy is nearly 5 years less for those with the lowest levels of education, compared to those with a high degree of post-secondary education attainment.”

“Race matters: Life expectancy in the Twin Cities swings widely from 83 years for Asians to 61.5 years for American Indians.”

“Neighborhood matters: Children born into the highest income areas live 8 years longer than those born into our poorest communities.”

The report methodically quantifies and explains how socio-economic status has every bit as much influence on health as the availability of health care-which is actually important in reducing health inequities-or the personal decisions one makes to eat right, exercise and avoid risks such as smoking or addictive substances.

The report concludes: “While debates over health insurance, fad diets, and the merits of various exercise regimes continue to capture the popular imagination, national research suggests that a person’s health is strongly influenced-as much as 50 percent or more-by social determinants.”

Another way to put this is that most people are not unhealthy by choice or moral failure. Our community is not some perfect meritocracy where everyone is where they are because they deserve to be there.

Moreover, although the findings are hardly shocking or new, most mainstream citizens think we are obligated as a community and through our governments to keep trying to improve the lives of all our citizens.

The conclusion of the report flatly acknowledges that “there is no one silver bullet” that slays this injustice, but rather “progress in this broad area requires the sustained attention of committed people and institutions.”

Massive increases in existing welfare programs and benefits, most agree, are not the answer, but neither is further damage to an already threadbare governmental safety net.

Self-help and growing awareness of health inequity in the affected communities, and attention to cultural integrity as a pathway to wellness, is one solution.

A panel discussion on the release of the report included encouraging testimony from Atum Azzahir, an African-American leader and president of the Cultural Wellness Center, and Justin Kii Huenemann, founding president of the Native American Community Development Institute.

Each talked about how “spiritual nourishment” of original cultural traditions is beneficial for health and wellness, illustrated by the fact that new immigrants from Africa and Latin America are considerably healthier than those that have been assimilated into a less healthy and highly commercialized and consumer-driven American culture.

But neglect by the majority culture, benign or otherwise, or retreat from our governmental obligations to narrow these ZIP code gaps is not a rational or humane option. These unhealthier places are where a fast-growing percentage of our children and the next generation of Minnesota workers actually live.

And the charitable and nonprofit leadership in Minnesota, as well as mainstream religious leaders, are nearly unanimous in their call for more public revenue and investment in education, health and the physical infrastructure of the poorest communities.

Against this consensus are these loud and over-exposed voters and politicians flocking to the Tea Party fad. A recent New York Times poll of Tea Party sympathizers revealed a clear lack of sympathy for social problems or those whose health is impaired by social determinants.

The poll showed, for instance, a basic hostility to immigrants in general and a much stronger than average agreement that “too much has been made of the problems of black people.”

Not surprisingly, Tea Partiers were much more likely than the general population to be male, over 45, white, and middle-income or high-income. (Being older, however, they would be more likely to be receiving their own form of governmental support in the form of Social Security or Medicare benefits-but apparently that doesn’t count.)

Lots of voices are being raised against this anti-government folly, but few have been as persuasive as Neal Peirce, columnist for the Washington Post Writers Group, a wise and moderate voice who has studied urban problems for decades.

Peirce wrote a stirring column recently about the historic public good and equalities achieved through government resolve, from Lincoln through Roosevelt.

“Citizen voluntarism, in cleaning up neighborhoods and helping the disadvantaged, is a huge asset,” Peirce wrote last week.

“But it is not a substitute for able, professional, investment-oriented government. If Tea Party-ism, national or local, forces us to forget our shared fortunes, we’ll face not just a threadbare, but a tremendously dangerous future.”

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Dane Smith is president of St. Paul-based Growth & Justice, a progressive research organization that focuses on economics and state-and-local budget issues. He also spent 30 years as a writer for the Star Tribune and Pioneer Press, where he delved into state, local and federal governments and politics.


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