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Thursday, June 2, 2011

Health gap: Minorities are at risk

Article by: Alejandra Matos, Star Tribune

An emphasis on exercise could help fight ethnic disparities.

Carlos Riera and his family used to spend their Sunday afternoons strolling around the mall or gathered around the television set in their northeast Minneapolis home. But this spring they traded their shopping bags and couch for a pair of cleats and a field of green grass.

Every Sunday, the Riera family plays soccer with the North East Independent Soccer League, as part of a larger community project to reduce tobacco use, increase exercise and improve health in the Latino community.

"Playing soccer is a different way for us to be entertained," Riera said. "It's a way for us to get out of the house, and another way for us to exercise."

Unlike the Riera family, however, many Hispanics and members of other Twin Cities minority groups get very little exercise -- especially compared to the nonminority community.

Federal health statistics show that residents of Hennepin and Ramsey counties get far more exercise than the national average -- but that minority communities in the two counties lag far behind.

Those numbers are a small window into the larger problem of health disparities between Minnesota's white and minority populations -- a gap that has troubled the state's health authorities for years.

"[Minorities] have grown from 5 percent [of the state's population] 20 years ago to almost 15 percent now, yet we have the largest health disparities in things like diabetes and cardiovascular disease,'' said Jose Gonzalez, director of the Minnesota office of minority and cultural health. "It's our populations of color that get impacted the most."

Hennepin County, for example, had the state's lowest obesity rate in 2006, at 23 percent. Yet its obesity rates for Hispanics, American Indians and blacks are above the national averages for those groups.

Similar ethnic disparities show up for chronic, costly diseases such as diabetes and heart disease.

Those gaps have grave consequences for the entire state, health authorities say.

"When any of us have problems with our health, we all pay for it in terms of insurance, or in taxes for state health programs," said Marc Manley, chief prevention officer for the Blue Cross Foundation. "If we as a state or community can do something to help [minorities] stay healthy, it helps us all financially."

Social determinants
Health disparities often reflect larger social factors such as poverty and education, according to Martha Roberts, supervisor of the physical activity and nutrition program for the Minnesota Department of Health.

The minority populations of Minnesota often live in low-income neighborhoods, where exercise and healthy groceries may be hard to get.

"If you live in a poor community, there may not be many parks or bike trails, and you may live in what is known as a food desert, where healthy food may not be available,'' Manley said.

To help counter those problems, in 2009 Minnesota launched the Statewide Health Improvement Program, which provides local health boards and tribal communities grants to fund programs such as Farms to Schools, where local farmers sell produce to school districts.

Gonzalez said that, although obesity and diabetes are largely influenced by diet, another factor needs to be addressed. "I think it has a lot to do with a lack of physical activity, especially in our students," he said.

According to the 2010 Minnesota Student Survey, 13 percent of 12th-grade Hispanic boys and 20 percent of girls said they don't get any exercise during the week, compared with 9 percent of white boys and 12 percent of white girls.

"Unless we go out there and do more, especially with our kids, the [health] disparities will continue," Gonzalez said.

Several other programs, not funded by the state, are also attempting to close the gaps. Comunidades Latinas Unidas en Servicio, or CLUES, is one. With funding from partners like the Minnesota Wells Fargo Foundation and the Xcel Energy Foundation, CLUES has programs targeted specifically at the Hispanic community, including home visits by volunteers to teach families how to cook healthier meals. It also helps fund the North East Independent Soccer League.

Soup and smoothies
Riera, his wife, Paulina, and their three children joined the league after Riera learned at his church about a program called the Diverse Racial Ethnic Groups and Nations project, which works to reduce tobacco use in the Hispanic community and promote healthful eating and exercise habits.

His children grew up watching him play soccer, and are now active in the league. "We don't have to push them to get to the games,'' he said. "If anything, they push us to go because they love playing soccer.''

Riera said he has taken advantage of both the soccer team and the nutrition advice.

"We tell our kids that if they eat their fruits and vegetables they will be stronger to play soccer,'' Riera said. "But sometimes they don't like everything we try to give them. We have to sneak it into their smoothies in the morning or in their soup so they don't notie it."

Jose Arrias, manager of the soccer league, said families like the Rieras are common in his organization, but that it's not always easy to get people to change their habits.

"We can give them all the information needed, but it's up to the individual to make those changes," Arrias said.

Alejandra Matos • 612-673-4028

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