Minnesota’s reputation for being one of the healthiest states in the nation is slipping. With obesity and binge drinking standing out as two of the most obvious reasons it fell from third to sixth place nationally in terms of health standards, Minnesota Commissioner of Health Dr. Ed Ehlinger has set out on a mission of discussion, brainstorming and horseshoe pitching in an attempt to reverse this downward trend.
“Things are not going in the right direction,” Ehlinger told a gathering of Isanti and Mille Lacs county commissioners, public health officials and private medical professionals last Tuesday afternoon at the Isanti County Government Center.
The meeting was part of Ehlinger’s “Pitch the Commissioner” campaign in which he is traveling across the state to find local solutions to improving the state’s health.
“As healthy as Minnesota is right now, it’s not because of what we are doing today, but the investments made 30/40 years ago,” Ehlinger said. “What kinds of investments can we make today that will benefit the people who come after us?”
Ehlinger’s goal is to reclaim Minnesota’s spot at the top of the nation in health measurements, and he’s looking for pitches — on the horseshoe pits and off — on ways to do so.
“I’m a physician and I recognized very quickly that my work wouldn’t create a healthy community without a lot of help from broader policies,” Ehlinger said.
While smoking has decreased in Minnesota, a drop Ehlinger attributes to policies such as the public smoking ban of 2006 and the most recent tobacco tax increase earlier this summer, binge drinking and obesity in the state are on the rise. The Land of 10,000 Lakes may still claim the No. 1 spot for ice fishing, but the heavy drinking among its populous places it 42nd in the nation. While the BMI of the overweight residents increases, the physical activity of this group has dropped considerably, Ehlinger explained.
The health commissioner said another factor driving the state’s drop in health standards is the dramatic disparity between Minnesota’s white and minority populations and its growing number of people living in poverty.
“We are becoming increasingly diverse and unless we bring those disparities down, we will continue to experience poor health,” he said. “Your zip code has more impact on your health than your genetic code and that’s really sad.”
While studies show that one’s education often determines one’s health, Ehlinger said Minnesota has dropped the ball on that aspect as well.
“Over the years, we’ve been decreasing our investment in education,” he said.
Ehlinger pointed to the education ranking in which Minnesota has dropped from 24th to 29th in 1994 and again it dropped to 38th in the nation in 2003 in terms of per capita spending on K-12 education.
“In 2009, for the first time, Minnesotans had to pay more than 50 percent of the cost of college through tuition,” Ehlinger said.
In order to find community solutions to improve the state’s health, Ehlinger said people need to understand what creates health in the first place. He said one’s health can be broken down into several categories, each representing only a piece of the puzzle. One’s genetics plays a 30 percent role; behavioral patterns account for 40 percent; social circumstances such as household income can factor as much as 15 percent; the environment such as one’s zip code claims 5 percent; while access and quality of health care accounts for just 10 percent of one’s health outcomes.
“You should bike more, you should eat better food,” Ehlinger said. “But what if you live in an unsafe neighborhood or in a food desert?”
He said that policies can help create environments and incentives for people to make better, healthier choices.
“For that $1.60 in tobacco taxes, we will have 30,000 people quit smoking,” he said. “That’s huge.”
At the local level, Ehlinger believes similar policy decisions can help propel Minnesota back to the top. That effort has been underway through community needs assessments, grants and benefits programs such as those offered by the Statewide Health Improvement Program, or SHIP, that has made local projects like the Milaca walking trails possible.
By making neighborhoods safer to be active in, ensuring residents have access to healthy food options and discouraging unhealthy behavior such as smoking and binge drinking, Ehlinger believes vast improvements can be made.
“I can’t make people do anything,” he said. “But we can make the environment as conducive to making the right decision as possible.”
After his presentation, Ehlinger asked those in attendance, including Isanti County Public Health Director Kathy Minkler, Isanti County Board Chair Susan Morris and other commissioners, as well as Mille Lacs County Public Health Director Janelle Schroeder and Commissioner Genny Reynolds, to join him for horseshoes and pitches for ways to improve the sister counties’ health.
“When you’re pitching horseshoes, you don’t want to be too far to the left, or too far to the right. You want to be straight down the middle,” Ehlinger said. “It should be the same with public health. Think about what you can do here in Isanti County and Mille Lacs County. All of us have some responsibility to the health of our community.”