Health is a state of complete physical, social, and mental well-being beyond just the absence of disease. In addition to biology and individual behaviors, health is created in the community through physical social, economic and environmental factors collectively called social determinants of health (SDOH). Health disparities are differences in health due to genetic, biological, social or economic disadvantages, Health inequities are disparities that are systematic, unjust and avoidable often due to unfair distribution of SDOH. Health equity calls for addressing these structural and societal (SDOH) factors responsible for most health inequities. Most disparities particularly racial and ethnic are rooted in unequal access SDOH to promote healthy behaviors. Health equity is a concept of health that comes from the ethical notion of distributive justice requiring an ethical distribution of resources.
A fundamental principle of public health is that all people have a right to health. Health should not be compromised because of an individual or population group’s race, ethnicity, gender, income, sexual orientation, neighborhood or other social condition. There’s no single definition for health equity. The most widely used definitions have a common focusing on elimination of disparities within different groups in society for everyone to have an equal opportunity at attaining the highest level of health possible. The City of Bloomington Public Health (BPH) is dedicated to pursuing health equity which calls for minimizing this systematic and unequal distribution of key social determinants of health. This is the first equity report produced by the agency that serves to identify health inequities and initiate the development of recommendations towards addressing these inequities locally.As the population diversifies and ages and social environments change, it becomes important for programs to assess and address consequent challenges and needs. This report includes the following indicators relevant to health equity in the three cities served by BPH-Bloomington, Edina and Richfield:
Maternal and Child Health
Income and Poverty
Inequities by race and ethnicity are highlighted where available.
Bloomington Public Health (BPH) acts on behalf of the Public Health Alliance of Bloomington Edina and Richfield (PHABER). The three cities are independent community health boards served by BPH. For past 40 years since the Local Public Health Act of 1976, BPH has served residents of the three cities of Bloomington Edina and Richfield (BER) in Hennepin County, Minnesota. BER is home to residents of varying age, race and ethnicity and socioeconomic backgrounds who face varying health determinants with equally varying outcomes. MDH identifies that structural racism includes several dynamics of historical, cultural and institutional practices that have advantaged white people over with negative health outcomes for people of color has been as a key variable towards health equity. Living conditions impact health in various ways including promotion or weakening of healthy behaviors and outcomes. Common areas of disparity include race, age, gender, income, education attainment and language proficiency.
Racial inequities exist in every indicator highlighted. Some compelling inequities include:
Higher rates of preterm births (born before 37 weeks of pregnancy) and babies of low birth weight (under five pounds, eight ounces) for black mothers.
Hispanics/Latinos followed by Blacks have the lower educational attainment.
Students of color report lower rates of social connectedness.
Black students have higher rates of suicide attempts while Hispanic students showed higher rates of ever having considered suicide.
Adverse Childhood Experience (ACES) are higher for Hispanic students. o Hispanic students reported higher substance use.
Hispanic students report lowest fruit and vegetable consumption and higher rates of obesity followed by Black students.
Home ownership disparities exist for Blacks and Latinos.
Gender inequities exist in:
Youth substance abuse, mental and physical health indicators including obesity.
Premature death rates.
Age inequities exist in:
Health outcomes of Maternal and Child Health (MCH). Disparities exist in preterm and LBW for teen moms.
Adequate usage of prenatal care is lower for teen moms.
Poverty inequities exist in:
Concentrated poverty is more pronounced in various census tracts of the cities. Some tracts show a higher percentage of residents under federal poverty level.
Households in high poverty tracts are more socially vulnerable and less prepared for disasters.
Less educated residents are more likely to live in poverty.
Geographical differences exist in various health outcomes highlighted for various indicators. By city, Bloomington, Edina and Richfield show differences in youth health outcomes as well as education attainment. Maps by census tracts are shared where available The Minnesota Department of Health MDH states that “advancing health equity requires explicitness about race and structural racism, especially the relationship of race to the structural inequities that contribute to health disparities”.
Inequities that exist within the three cities are described in this report for future work to explore why these differences exist in order better understand how to support and improve the health of everyone in our communities. This report can be used as an engagement tool with various stakeholders that include community members towards facilitating lasting policy changes that will benefit the community.