Fight for fair provision of health services in Minnesota isn't over

State health officials worked last week to increase COVID-19 vaccination rates of Minnesotans of color, amid the disclosure that they are being inoculated at half the pace as people who are white.

This is just the latest example of the fight against discrimination in the provision of health care in Minnesota. And it's something that leaders of insurance companies and hospital systems have given more attention and resources to in recent years.

Data show much higher levels of infant mortality, as well as asthma, obesity and diabetes among people of color in the state.

In 2015, Dr. Ed Ehlinger, who was then Minnesota's health commissioner, warned leaders to stop "admiring the problem."

A 2018 study by the University of Minnesota found that the annual price of racial inequity is 766 lives that are lost due to preventable maladies. It found that more than 1,000 Minnesotans are out of work because their health care is worse than it should be.

The death of George Floyd in police hands last summer thrust even more attention on racial inequality in Minnesota. And yet a poll this winter for Blue Cross Blue Shield of Minnesota found 42% of Minnesotans say racism is not a significant problem. However, 80% of Black, American Indian, Latinx and Asian Pacific Islanders in that poll said it is.

Dr. Craig Samitt, the chief executive of Blue Cross Blue Shield of Minnesota, had one word for that: "Sobering."

"We call on [white-owned] business and individuals … to shift from a 'none-of-my-business' mind-set and instead make racism and its impact on health everyone's business," Samitt said.

There's anecdotal and quantified evidence, including initiatives from Blue Cross, that business is responding.

Vayong Moua, director of racial and health equity at Blue Cross, immigrated as a toddler to Eau Claire, Wis., in 1976 with his Hmong family from Laos. Southeast Asians, albeit welcomed by many, struggled with education, employment opportunity and racism. Some Americans forget how the Hmong fought alongside U.S. troops in the Vietnam War.

Moua remembers being taunted with slurs.

"My parents and other people of color helped to strengthen the equity capacity of the city and public health," Moua said. "Racism is everywhere. There also were good, well-intended, empathetic people. "

Moua, 45, a St. Olaf College graduate, worked on the Blue Cross-Minnesota lawsuit against the tobacco industry that resulted in a landmark 1998 settlement. Big Tobacco conspired for years to addict teens and target minorities, even the executives knew of the deadly costs to smokers, those around them and society.

"Racial equity cannot rely on enlightenment alone," Moua said. "We must go after behavior and systems. It's about power and prioritization. It can't be contingent on just empathy and education.

"We all pay the price for racism and health inequities. If you want healthy people and a talented workforce and to prevent these costs, commit and it will be good for the overall common good. There's economic reason and moral imperative."

Blue Cross and partners want us to test our knowledge and presumptions. Racism is more subtle and permeable than we may think. At the bluecrossmn.com/healthequity website, you will find myth-busting facts and insights into historic elevation of white culture in education, media and business; often to the exclusion of others.

Diversity and inclusion should be enriching, interesting and rewarding. We all have benefited from a half-century of opening jobs and the economy, albeit grudgingly and sometimes unfairly, to women and people of color. The economy, in business, art, sport, medicine and manufacturing also grew, thanks to them.

There was employment growth in technology, health care, building trades and business management, markedly between 2010 and 2019. Still, racial gaps in education, income and homeownership persist.

White executives at companies such as SPS Commerce and Ryan Cos. have been enlightened recently by Yohuru Williams, who leads the University of St. Thomas Racial Justice Initiative.

Bill Green, a professor of Augsburg University, where 40% of graduating classes are minorities, is a lawyer and acclaimed author on post-Civil War discrimination in Minnesota. Pillsbury House Theatre presents compelling productions about interpersonal racial interaction and understandings. It's good to test our awareness.

The discrimination that began in slavery descended through the decades since 1865 in the form of Jim Crow laws, mortgage redlining, voter suppression and other oppressive forms.

Economists find inclusion drives growth. By 2035, 25% of Minnesotans will be people of color.

We all do better when we all do better.

Neal St. Anthony has been a Star Tribune business columnist and reporter since 1984. Reach him at nstanthony@startribune.com.