Monday, June 23, 2014

Do you have a library card?

Even though I’ve lived in Minnesota for over three decades and have been involved with myriad literacy and reading programs, I didn’t know that Minnesota had a state librarian until about a month ago. I knew we had a state demographer, a state economist, a state forester, and a state climatologist, but it took Elmo from Sesame Street to introduce me to Jennifer Nelson, Minnesota’s State Librarian. 

It was after an event at the Brookdale Library highlighting what Sesame Street was doing to address the needs of children of incarcerated parents that I had a chance to tour the library and hear about the roles that libraries play in protecting and creating health in our communities. I saw firsthand that libraries are much more than a place to just store and check out books. They are places where one can go for personal and professional development while, among numerous other things, also providing meeting spaces, enhancing cultural engagement, supporting literacy for all ages, encouraging community involvement, and improving the overall quality of life in a neighborhood. I learned that there are more libraries in the U.S., than McDonald’s restaurants. There are over 350 public libraries in Minnesota which are available to everyone regardless of socio-economic circumstances. And you can use them even if you don’t have a library card. The card is needed only if you check out something.

Recognizing the role that libraries play in public health in our state, I invited the State Librarian to be a guest on my cable TV show – A Public Health Journal. At last week’s taping we discussed the history of libraries, their current activities, and their changing role in our increasingly diverse and digital world. I learned that libraries remain crucial to the health of our state and are providing a broader range of services today than ever before. It was during that conversation that I also learned that the position of State Librarian is celebrating its 100th anniversary.

I end every episode of my show with a closing comment. Here is my closing for the show that featured the State Librarian: 

When I was a practicing pediatrician, I would ask three questions of every parent: does your child know how to swim, have you visited the state capitol, and do you and your child have a library card? 

You may wonder what those questions have to do with the health of a child. Knowing how to swim should be obvious, it is a life-saving skill. It fits in the same category as wearing your seat belt and bicycle helmet and looking both ways before crossing a street. It’s a personal behavior that protects you from harm.

Visiting the capitol on the other hand highlights the community aspects of health. We all live in a community and the health of our community affects our health. Only by actively participating in how our communities are built and governed will we be able to assure that our communities are healthy. Visiting the capitol underscores for children the importance of community engagement and that engaged communities are healthy communities.

The library card is about opportunities. It offers the opportunity for education and learning, for growth and development, for exploration and discovery. A library card provides opportunities to examine the past, explore the present, and create the future

More importantly, the library card is about dreams. It stimulates dreams about the future, about a child’s place in the world, about possibilities.

Kids need to know how to swim. They really should visit the capitol. But most of all they need to dream and have the opportunities for those dreams to come true. Do you and your child have a library card?

I ask you the same question.


Monday, June 16, 2014

Advancing Health Equity by sharing data

As part of our Advancing Health Equity agenda, the Minnesota Department of Health has been looking for ways to ensure that all people in Minnesota have the opportunity to be healthy. One way is to address the social determinants of health. Since income is probably the most influential social determinant of health, we welcomed the opportunity to submit a White Paper to the legislature on “Income and Health.” (PDF: 936KB/36 pages). That paper helped broaden the conversation around the minimum wage bill that was in front of our legislature. Our report showed that raising the income of the lowest paid workers had a significant impact on improving their health. People began to see minimum wage as a public health issue, not just a jobs issue. I believe our report helped move the discussion along at the Capitol that led to passage of a minimum wage bill in MN that increases the minimum wage to $9.50/hour and links it with inflation.

Our report has also been read by people in multiple community organizations and used in their efforts to enhance the economic stability of members of their community. One of those groups is Centro de Trabajadores Unidos en la Lucha (CTUL), a group representing the cleaning crews for the Target Corporation. They used the MDH report in negotiating with Target for improved, wages, benefits, and working conditions. Following those negotiations, Target announced last week that they are adopting a Responsible Contractor Policy, the first of its kind in the retail industry. Here is a link to the CTUL website:

To me, using data to define the context of what creates health and getting that information and analysis into the hands of the people/communities most impacted by existing policies, systems, and programs is one of the ways in which public health can help assure that everyone has the opportunity to be healthy. It can sometimes be difficult to see the impact of this kind of analysis on the health of individuals, but I think this is one circumstance where the application of work done at MDH will make a significant difference to folks at the bottom of wage scale and their families. Most people will not make the connection between public health and the CTUL/Target settlement but it will show up in the health statistics that we will see over the next decade – an outcome that should be a source of pride for all of us in public health.


Tuesday, June 3, 2014

Open Streets – North Minneapolis Greenway Experience

On Saturday, while participating in this summer’s first Open Streets event, lines from a couple Maya Angelou poems kept running through my mind. Given that Angelou had died just three days earlier and that I was biking with members of the Major Taylor Bicycle Club (an African-American bike club) through north Minneapolis, I wasn't surprised that verses from "Still I Rise" and "Million Man March" were rising into my consciousness and marching through my brain.  

Biking down Humboldt Avenue North and seeing the remnants of the house and tree damage caused by the tornado 3 years ago and the foreclosed homes and vacant lots caused by predatory lending of the last decade and years of community-level poverty, I could hear the poet clearly lament:

The night has been long,
The wound has been deep,
The pit has been dark,
And the walls have been steep. 
Million Man March

But the mood was not one of sadness or defeat. Instead, there was joy in the air and it was contagious as our group pedaled through the neighborhood. There were bikers everywhere. Those who weren't biking were laughing, waving, and enjoying the spectacle. Many of the vacant lots were slowly being reclaimed by sprouting vegetables – part of a network of community gardens. Schools and churches along the route were offering food and music. Dance groups were performing on temporary stages at several venues. Tents put up by community agencies lined the streets and offered education, information, connections, and water. And community members were beaming as they interacted with each other. Among this hubbub I could envision a triumphant smile on the face of Maya Angelou as she demanded:

I say, clap hands and let's come together in this meeting ground,
I say, clap hands and let's deal with each other with love,
I say, clap hands and let us get from the low road of indifference,
Clap hands, let us come together and reveal our hearts,
Let us come together and revise our spirits,
Let us come together and cleanse our souls

Clap hands, call the spirits back from the ledge,
Clap hands, let us invite joy into our conversation,
Million Man March

And there was joy in this Open Streets community-building conversation/event that couldn't be dampened even by the threat of rain. 

Our Advancing Health Equity report outlined many of the policies and structural inequities that have disadvantaged communities of color and American Indians in our state and it highlighted many of the health disparities that have resulted. It did one of the things that public health is supposed to do - redefine the unacceptable. What hasn't received as much attention is the more uplifting role of public health that the report suggested – assure the conditions in which people can be healthy. Engaging and empowering communities in creating opportunities to be healthy is one of the best ways to do that. Community engagement and empowerment is what I saw rising up last weekend in one of the poorest and most stressed neighborhoods in Minneapolis.

Out of the huts of history's shame
I rise
Up from a past that's rooted in pain
I rise
I'm a black ocean, leaping and wide,
Welling and swelling I bear in the tide.
Leaving behind nights of terror and fear
I rise
Into a daybreak that's wondrously clear
I rise
Bringing the gifts that my ancestors gave,
I am the dream and the hope of the slave.
I rise
I rise
I rise.         
Still I Rise

Despite the magnitude and seeming intractability of the disparities in our state, I am optimistic that we can achieve health equity. Community after community is showing us how to make that happen.  Health equity is on the rise.