"Social Determinants of Health" Sounds complicated? Sounds like jargon? It's not, really. In fact, an excellent seminar yesterday, sponsored by Blue Cross/Blue Shield, shed light on how education, income, and the features of the places where we live literally add or subtract years from our lives.
For example, people who don't graduate from high school earn less during their lives than people with more education. You might expect that, but statistics show that they also more often suffer from obesity and cancer; they die at earlier ages. A major study in England, featured in a to-be-released PBS series, shows a strong and direct correlation between income (or social status) and health status and life expectancy.
In the past, we have tended to put emphasis on individual choices and behaviors as the factors that affect our health. If we choose to smoke, our health will suffer; if we choose to exercise, we will remain fit and less likely suffer from many chronic diseases. We have also recognized that we inherit some characteristics from our parents; as the New York Times reported today, commonly-available DNA testing will soon enable everyone to "learn what is known so far about how the billions of bits in their biological code shape who they are."
Our DNA, and the lifestyle choices we make, do influence our health. However, they might explain only a fourth or a third of the differences among people. The research summarized yesterday by Dr. Anthony Iton, suggests that individual choice might account for only 15-30% of the explanation for why some people stay healthier, and live longer, than others. It also showed strong differences in disease rates and life expectancy depending upon people's places of residence. Even within the same geographic areas (Alameda County CA was one example; Louisville KY was another.), residents living just a few miles from one another show great differences in health, in a very predictable pattern: neighborhoods with poorer, less educated residents, with worse housing, with higher levels of uncollected waste, live shorter, less healthy lives. And, this pattern does not just influence the lives and well-being of poor people. Residents of middle class neighborhoods can live 3-5 years less than residents of wealthier neighborhoods.
If you think that these issues do not apply in Minnesota, think again - and watch for data we will report in our Twin Cities Compass project. Disparities do exist. They have real effects, as you will see. The Brookings report, "Mind the Gap", sponsored by the Itasca Project identified disparities based on race, income, and place as some of the most significant challenges for the future vitality of our region.
It's immoral, in my opinion, that we should have these disparities. Total equality might not be possible, but we can certainly bring everyone to a minimum level of education, so they can participate in work life and civic life. We can certainly narrow the gaps to a minimum.
Perhaps the moral argument makes sense, but still does not sway you - consider the practical side. Health disparities affect you very directly. Health disparities cost you money right now, and they jeopardize your future well-being, regardless of your social status. People of color constitute the growing populations in our region. They make up the work force of the future, the parents of the future, the leaders of the future. If the up-and-coming part of our community is less healthy now, we all pay in the form of increased insurance costs and taxes; if they have poor health, and die earlier, in the future, we all lose the value of their productivity and the many contributions they can make to our society.
There is little doubt that we must understand the "social determinants of health" and address the disparities in our region, if we want our region to stand out internationally as one of the best places to live.
(Watch for the PBS documentary, Unnatural Causes, next year. Watch also for the TPT series on disparities in the Twin Cities region, and their effects on all of us. Twin Cities Compass and Wilder Research are partnering with the Itasca Project and TPT on education and follow-up activities for that series.)
Saturday, November 17, 2007
Monday, November 12, 2007
Veterans Who Are Homeless
About one in four homeless men in Minnesota are military veterans. 600+ veterans live in shelters or on the street; most are men, but a few are women. Let's remember them on this Veterans Day.
Perhaps most tragic is that some of our veterans from the Iraq/Afghanistan conflicts are among the homeless. Many in this country oppose the war, but regardless of our opinion about whether we should have our military in Iraq, it seems unconscionable that we can't care for those who so recently served their country in the military.
Wilder Research has conducted a statewide homeless study every few years since the early 1990s; we conducted it on a more limited level beginning in the early 1980s. Over the years, we witnessed increases in the number of homeless people, with especially large increases in the number of children. Evidence from our most recent study indicates that the total number of homeless people might have leveled off, or even declined slightly.
That's good news, if it holds up when we repeat the study in 2009. Nonetheless, we cannot rest on our laurels, even if we have really turned the tide. Work remains to be done.
Last week, the Minneapolis Foundation brought together hundreds of people concerned about homelessness. We looked at the Wilder study data; we listened to Housing Finance Agency Commissioner Tim Marx describe how we can take action. Paul Williams, Richard Amos, and Gabrielle Strong highlighted the practical issues that challenge us, along with homeless people themselves, if we want to solve this issue.
We look forward to continuing to shed light on homelessness. If our collaborative effort to end long-term homelessness succeeds, it will be testimony to the strength and the will of Minnesotans to show compassion for the vulnerable and to include in our economy and civic life all who want to make their homes here, but have run into a few extraordinary difficulties in doing so.
Perhaps most tragic is that some of our veterans from the Iraq/Afghanistan conflicts are among the homeless. Many in this country oppose the war, but regardless of our opinion about whether we should have our military in Iraq, it seems unconscionable that we can't care for those who so recently served their country in the military.
Wilder Research has conducted a statewide homeless study every few years since the early 1990s; we conducted it on a more limited level beginning in the early 1980s. Over the years, we witnessed increases in the number of homeless people, with especially large increases in the number of children. Evidence from our most recent study indicates that the total number of homeless people might have leveled off, or even declined slightly.
That's good news, if it holds up when we repeat the study in 2009. Nonetheless, we cannot rest on our laurels, even if we have really turned the tide. Work remains to be done.
Last week, the Minneapolis Foundation brought together hundreds of people concerned about homelessness. We looked at the Wilder study data; we listened to Housing Finance Agency Commissioner Tim Marx describe how we can take action. Paul Williams, Richard Amos, and Gabrielle Strong highlighted the practical issues that challenge us, along with homeless people themselves, if we want to solve this issue.
We look forward to continuing to shed light on homelessness. If our collaborative effort to end long-term homelessness succeeds, it will be testimony to the strength and the will of Minnesotans to show compassion for the vulnerable and to include in our economy and civic life all who want to make their homes here, but have run into a few extraordinary difficulties in doing so.
Wednesday, October 03, 2007
Becoming a "Greener" and Stronger Community
Improving the well-being of our communities requires, obviously, that we address local issues and concerns. However, it also requires attention to national, international, and global issues. The quality of our environment, while it may seem like something over which we have little control, is one of those issues that relates fundamentally to our local quality of life. We need to do our part to preserve and enhance the environment.
For example, Wilder has a commitment to build an energy-efficient structure for our new Wilder Center at the corner of Lexington and University in Saint Paul. We hope to receive gold certification for the building; we'll be one of very few such buildings in the state, but hope that we are one of many over the next 10 years.
My annual visit to the Minnesota State Fair a month ago prompted me to wonder if we could make major progress toward a better environment through simple steps at public events like the Fair. Can the State Fair take visible action toward reducing waste and, through its example, educate Fair-goers, who will then increase their attention to environmentally friendly behavior?
One thing that struck me: the number of disposable items - cups, spoons, napkins, etc., -distributed by vendors, used by patrons for only a few minutes, and then discarded. Why not require that Fair-goers bring their own cups, or purchase one "souvenir cup" from the Fair, and then have vendors dispense portions into those cups? This could greatly reduce the 1,000 plus tons (2 million plus pounds) of garbage that the Pioneer Press reported the Fair produces. More important, though, it brings 125,000 people per day to realize that they should, and can, do their part for the environment.
Vaclav Havel, the author and a former president of the Czech Republic wrote recently that "Maybe we should consider our sojourn on earth as a loan. There can be no doubt that for the past hundred years at least, Europe and the United States have been running up a debt, and now other parts of the world are following their example. Nature is issuing a warning that we must not only stop the debt from growing but start to pay it back."
If all of us listen to nature's warning and do our small parts for the environment, the collective result will be very positive. We'll help the world, and we'll help the Twin Cities region!
For example, Wilder has a commitment to build an energy-efficient structure for our new Wilder Center at the corner of Lexington and University in Saint Paul. We hope to receive gold certification for the building; we'll be one of very few such buildings in the state, but hope that we are one of many over the next 10 years.
My annual visit to the Minnesota State Fair a month ago prompted me to wonder if we could make major progress toward a better environment through simple steps at public events like the Fair. Can the State Fair take visible action toward reducing waste and, through its example, educate Fair-goers, who will then increase their attention to environmentally friendly behavior?
One thing that struck me: the number of disposable items - cups, spoons, napkins, etc., -distributed by vendors, used by patrons for only a few minutes, and then discarded. Why not require that Fair-goers bring their own cups, or purchase one "souvenir cup" from the Fair, and then have vendors dispense portions into those cups? This could greatly reduce the 1,000 plus tons (2 million plus pounds) of garbage that the Pioneer Press reported the Fair produces. More important, though, it brings 125,000 people per day to realize that they should, and can, do their part for the environment.
Vaclav Havel, the author and a former president of the Czech Republic wrote recently that "Maybe we should consider our sojourn on earth as a loan. There can be no doubt that for the past hundred years at least, Europe and the United States have been running up a debt, and now other parts of the world are following their example. Nature is issuing a warning that we must not only stop the debt from growing but start to pay it back."
If all of us listen to nature's warning and do our small parts for the environment, the collective result will be very positive. We'll help the world, and we'll help the Twin Cities region!
Wednesday, August 29, 2007
Achievement Gap
The "Achievement Gap" refers to the differences between white children and children of color on measures of academic performance. For example, White children are about twice as likely to score proficiently on reading and math tests, and twice as likely to graduate from high school on time, compared with African-American children.
The gap presents a challenge to our region because children of color constitute a rapidly growing segment of our population; they represent the majority of students in the Minneapolis and Saint Paul schools. They represent a signficant portion of our future.
The Superintendent of the Saint Paul Schools announced that she wants to close this gap. According to reports appearing in the August 24 Pioneer Press and StarTribune, she intends to develop a plan that will engage the community to work toward equal educational outcomes for all students.
The education achievement gap is not new; it is not local. Wilder Research began formally reporting it in the early 1990s, as did others around the country. It had been identified even before then.
Dan Mueller of Wilder Research outlined a number of strategies that research demonstrates can reduce or eliminate the gap. These include: high quality, center-based preschools; elementary schools that have a strong focus on teaching and learning (minimizing distractions for other purposes, for example); schools that have a rigorous curriculum; schools that align their curriculum and instruction with their assessment process; effective school leadership; strong teacher professional development programs; and others.
Note that income differences do not fully explain the achievement gap; note also that different racial groups tend to score differently. And remember that the numbers are typically averages; within each racial group, you can find students who perform well and students who do not.
The Superintendent intends to create a plan in the coming months. I encourage her to consider both short-term and long-term strategies, as the research suggests. For some students, improvement can likely occur rapidly. Complete closure of the gap, for all students, will take longer.
Saturday's Pioneer Press reported that she will institute new "training" in which "outside consultants" will "observe staff members at work and advise them on areas of potential racial, socio-economic and gender bias." This will start with clerks and the executive team; observations of teachers will not occur at first. Research evidence does not yet exist to indicate that such training will substantially close the gap, but potentially it can begin to enhance the atmosphere of schools and the day-to-day behaviors of front line staff in ways that will foster better learning environments for children of all colors.
Closing the gap will require changes in the cultures of schools, other organizations, the community, and families. It will require joint efforts among many of us in Saint Paul. It will require that we all share responsibility; we will need to move beyond blame and finger-pointing and take special care not to "blame the victim".
If you have looked at the research, you know that elimination of the achievement gap will only occur if our schools change. That will cause stress and discomfort. However, our schools cannot accomplish this alone. We all need to pitch in, and we all might experience some discomfort in the short run.
Are we ready? I think that many of us are. If we pay attention to the evidence on what does work to close the gap, and if we make a steadfast effort, we can succeed to overcome one of the most significant challenges to the future of our region.
(You can learn more about the research on the achievement gap in the paper by Dr. Dan Mueller, "Tackling the Achievement Gap Head On" on the Wilder Research web site.)
The gap presents a challenge to our region because children of color constitute a rapidly growing segment of our population; they represent the majority of students in the Minneapolis and Saint Paul schools. They represent a signficant portion of our future.
The Superintendent of the Saint Paul Schools announced that she wants to close this gap. According to reports appearing in the August 24 Pioneer Press and StarTribune, she intends to develop a plan that will engage the community to work toward equal educational outcomes for all students.
The education achievement gap is not new; it is not local. Wilder Research began formally reporting it in the early 1990s, as did others around the country. It had been identified even before then.
Dan Mueller of Wilder Research outlined a number of strategies that research demonstrates can reduce or eliminate the gap. These include: high quality, center-based preschools; elementary schools that have a strong focus on teaching and learning (minimizing distractions for other purposes, for example); schools that have a rigorous curriculum; schools that align their curriculum and instruction with their assessment process; effective school leadership; strong teacher professional development programs; and others.
Note that income differences do not fully explain the achievement gap; note also that different racial groups tend to score differently. And remember that the numbers are typically averages; within each racial group, you can find students who perform well and students who do not.
The Superintendent intends to create a plan in the coming months. I encourage her to consider both short-term and long-term strategies, as the research suggests. For some students, improvement can likely occur rapidly. Complete closure of the gap, for all students, will take longer.
Saturday's Pioneer Press reported that she will institute new "training" in which "outside consultants" will "observe staff members at work and advise them on areas of potential racial, socio-economic and gender bias." This will start with clerks and the executive team; observations of teachers will not occur at first. Research evidence does not yet exist to indicate that such training will substantially close the gap, but potentially it can begin to enhance the atmosphere of schools and the day-to-day behaviors of front line staff in ways that will foster better learning environments for children of all colors.
Closing the gap will require changes in the cultures of schools, other organizations, the community, and families. It will require joint efforts among many of us in Saint Paul. It will require that we all share responsibility; we will need to move beyond blame and finger-pointing and take special care not to "blame the victim".
If you have looked at the research, you know that elimination of the achievement gap will only occur if our schools change. That will cause stress and discomfort. However, our schools cannot accomplish this alone. We all need to pitch in, and we all might experience some discomfort in the short run.
Are we ready? I think that many of us are. If we pay attention to the evidence on what does work to close the gap, and if we make a steadfast effort, we can succeed to overcome one of the most significant challenges to the future of our region.
(You can learn more about the research on the achievement gap in the paper by Dr. Dan Mueller, "Tackling the Achievement Gap Head On" on the Wilder Research web site.)
Thursday, August 02, 2007
The 35W Bridge in Minneapolis
Does civic engagement affect our responses to metal fatigue? Probably yes, as I reflected upon it this morning.
Everyone in Minnesota, and many throughout the nation and the world, watched events unfold Wednesday evening in the aftermath of the collapse of the bridge over the Mississippi River. Today, we could view a tape of the actual collapse. The victims and their families have directly experienced a tragedy, and continue to do so; all of us feel the effects.
Today, the morning after the collapse, I had an 8:00 a.m. meeting with an advisory committee to discuss how to measure "Civic Engagement" as part of our Twin Cities Compass initiative, intended to measure the quality of life in the Twin Cities region. Prior to the meeting, I had wondered if committee members would attend, given the emotionally stressful events of the previous evening, not to mention potential traffic problems in the morning. I even had considered canceling the meeting.
I'm glad we met, not just because we productively accomplished our work, but because the meeting offered me the chance to reflect on the fact that civic engagement does very much relate to what happened to the bridge and on the bridge.
We have structures and infrastructures of all kinds in this world. They enable us to travel, communicate, and get important things done. Similar to people, they get old. Bridges get old.
Who should decide when to replace an aging bridge - engineers and other technicians? public officials? the general public? The experts gave this bridge a "sufficiency rating" of 50%, meaning from their point of view that it "might" need to be replaced; they rated its "structural members" at 4 on a scale of 9. Should it have been replaced? Who decides?
These decisions are not purely technical. They involve values; they involve hard decisions about costs. They pit different needs against one another, since money spent on bridge replacement cannot pay for something else. The decisions have implications that people feel directly, for example, in the time it takes them to travel, and in the taxes they have to pay.
Good decisions require informed and engaged members of the community. Productive action must be nonpartisan (or cooperatively multi-partisan), not motivated by attention only to rigid political or ideological agendas. Long-term thinking (which some politicians will not do) is required.
So, when we consider what happens to bridges, roads, and other physical structures, we must remain aware that our action or inaction, our interest or apathy, determine how safe we will be when we ride in cars, buses, trains, and planes. For the 35W bridge, some person or persons made the decision that the 50% rating was good enough not to make structural work a priority. Perhaps more people should be involved in that type of decision, in addition to many other decisions that literally affect our lives.
What about on the bridge? There we saw civic engagement at its finest in a crisis situation. Everyone - our police and fire services, service agencies like the Red Cross, nearby residents, passers-by, drivers (some of whom narrowly missed catastrophe), and others - pitched in, in some cases risking their lives.
I could not be near enough to get on that bridge to help people last night; but I'm very happy to be part of a process that can bring our region together to examine our trends and needs and to get mechanisms in place that will prevent future tragedies of this type.
That's why our meeting this morning - while it might seem remote from the victims, the crushed cars, the jumbled slabs of concrete - while it might seem irrelevant to engineering studies and reports - has great significance. We need civic engagement; we need good information that engaged citizens can use. Our lives and well-being depend on it.
As a footnote, three of the thirteen people in the room this morning had a close connection to victims on or near the bridge at the time of the collapse. One of these victims was seriously injured and is waiting for a decision about surgery. So, 3 of 13 at "one degree of separation" from people directly involved; my guess is that the rest of us in the room are only "two degrees" separated from the tragedy - that is, we most likely know someone who is personally linked to a victim.
That shows how much of a community we are - and demonstrates how important it is for us, as community members to make our region a better place to live!
Everyone in Minnesota, and many throughout the nation and the world, watched events unfold Wednesday evening in the aftermath of the collapse of the bridge over the Mississippi River. Today, we could view a tape of the actual collapse. The victims and their families have directly experienced a tragedy, and continue to do so; all of us feel the effects.
Today, the morning after the collapse, I had an 8:00 a.m. meeting with an advisory committee to discuss how to measure "Civic Engagement" as part of our Twin Cities Compass initiative, intended to measure the quality of life in the Twin Cities region. Prior to the meeting, I had wondered if committee members would attend, given the emotionally stressful events of the previous evening, not to mention potential traffic problems in the morning. I even had considered canceling the meeting.
I'm glad we met, not just because we productively accomplished our work, but because the meeting offered me the chance to reflect on the fact that civic engagement does very much relate to what happened to the bridge and on the bridge.
We have structures and infrastructures of all kinds in this world. They enable us to travel, communicate, and get important things done. Similar to people, they get old. Bridges get old.
Who should decide when to replace an aging bridge - engineers and other technicians? public officials? the general public? The experts gave this bridge a "sufficiency rating" of 50%, meaning from their point of view that it "might" need to be replaced; they rated its "structural members" at 4 on a scale of 9. Should it have been replaced? Who decides?
These decisions are not purely technical. They involve values; they involve hard decisions about costs. They pit different needs against one another, since money spent on bridge replacement cannot pay for something else. The decisions have implications that people feel directly, for example, in the time it takes them to travel, and in the taxes they have to pay.
Good decisions require informed and engaged members of the community. Productive action must be nonpartisan (or cooperatively multi-partisan), not motivated by attention only to rigid political or ideological agendas. Long-term thinking (which some politicians will not do) is required.
So, when we consider what happens to bridges, roads, and other physical structures, we must remain aware that our action or inaction, our interest or apathy, determine how safe we will be when we ride in cars, buses, trains, and planes. For the 35W bridge, some person or persons made the decision that the 50% rating was good enough not to make structural work a priority. Perhaps more people should be involved in that type of decision, in addition to many other decisions that literally affect our lives.
What about on the bridge? There we saw civic engagement at its finest in a crisis situation. Everyone - our police and fire services, service agencies like the Red Cross, nearby residents, passers-by, drivers (some of whom narrowly missed catastrophe), and others - pitched in, in some cases risking their lives.
I could not be near enough to get on that bridge to help people last night; but I'm very happy to be part of a process that can bring our region together to examine our trends and needs and to get mechanisms in place that will prevent future tragedies of this type.
That's why our meeting this morning - while it might seem remote from the victims, the crushed cars, the jumbled slabs of concrete - while it might seem irrelevant to engineering studies and reports - has great significance. We need civic engagement; we need good information that engaged citizens can use. Our lives and well-being depend on it.
As a footnote, three of the thirteen people in the room this morning had a close connection to victims on or near the bridge at the time of the collapse. One of these victims was seriously injured and is waiting for a decision about surgery. So, 3 of 13 at "one degree of separation" from people directly involved; my guess is that the rest of us in the room are only "two degrees" separated from the tragedy - that is, we most likely know someone who is personally linked to a victim.
That shows how much of a community we are - and demonstrates how important it is for us, as community members to make our region a better place to live!
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