The Caledonia Argus
Minnesota Health Commissioner Dr. Ed Ehlinger visited Caledonia Elementary School on Monday, July 31, kicking off his sixth annual slate of “Pitch the Commissioner” events.
Ehlinger met with nearly 30 people, including Houston County Commissioner Fred Arnold, Houston County Human Services director John Pugleasa, Houston County Public Health/Nursing director Mary Marchel, Caledonia Public Schools Elementary principal Gina Meinertz, and others, including other county employees and interested citizens.
Following a talk on the challenges of improving the overall health of local communities, Ehlinger pitched horseshoes with attendees.
“I go around the state pitching horseshoes with folks, because I find that Minnesotans talk better when they’re not looking at you right in the eye…” the commissioner said. “It’s much better to talk while they’re doing something and you’re walking back and forth.
“Pitch me ideas on what works in your community, and what doesn’t work… We want to know what to do at the state level to help, because one of my goals is to have a strong state/local partnership.
“That’s why I go around the state, looking at what’s working and what’s not.”
Ehlinger mentioned his practice as a pediatrician, but challenged the group to look at a bigger picture than just doctors and hospitals.
“We invest way more money in medical care than we invest in anything else…” he stated. “The data show that the more we invest in medical care, the more we fall behind other countries in terms of health.
“For every dollar we spend on medical care, we spend 55 cents on public health and social services… In other developed countries, for every dollar they spend on medical care, they spend two dollars on public health and social services…
“That’s why the United States is falling farther and farther behind in terms of life expectancy, infant mortality, and maternal mortality.”
For the Minnesota Department of Health, “health equity” is a watchword, he stated. The organization’s “triple aim of health equity” is: “To expand our understanding of what creates health,” incorporate “health in all policies” and “strengthen the capacity of communities to create their own healthy future.”
Social-economic conditions, things like living conditions, a sense of safety, clean air, clean water, and business development contributes a big part of the total when the health of a community is considered, Ehlinger noted. Health care actually contributes only about “10% of our overall health.” Behaviors can contribute about 30%. But the biggest part lies elsewhere, he said.
“I believe that probably 75% of all health is dictated by the social economic factors in communities,” Ehlinger stated.
Attendees said that living in a border county presents special challenges.
“The people that we serve in (Houston County) Human Services don’t see a big black line between Minnesota and Wisconsin,” Pugleasa noted. “Especially in a rural community that has a regional center that’s in a different state. “I’m more than willing to have conversations with my counterparts in La Crosse, but there’s all kinds of reasons why we can’t. So we need the state voice as well to kind of pave the path to that.
Ehlinger agreed that more talk and possible cooperation across state lines could be profitable. Local, organized demand for that to happen would be a key, he added.
“Our goal is to create healthy communities wherever they are at…” Ehlinger said. “I don’t want Minnesota to be the healthiest state in the country. I want every state to be as healthy as possible. Because if Mississippi is not healthy, we’re not as healthy as we could be… Health is not a zero sum game. If you raise the people at the bottom, people at the top don’t go down. Actually, the people at the top get better.
“That’s the reason why rich, white folks in the United States are not as healthy as middle income white folks in Europe. Because of our disparities. When our infant mortality started to increase, diverge from the rest of the world, and when our longevity started to slow down compared to the rest of the world, it’s when our disparity started to increase. The disparities actually impact everybody.”
Participants agreed with the commissioner on the importance of clean water and clean air to the health of a community. Another point of consensus was the value of SHIP (Minnesota’s Statewide Health Improvement Partnership).
Ehlinger said that SHIP “is to chronic diseases what vaccines are to infectious diseases.”
Working at a local level, the focus of SHIP has been on physical activity, nutrition, and tobacco control, the commissioner stated. But more importantly, the program works on policy, systems, and environmental change, he added.
And public involvement – such as voting – also drives the issue, Ehlinger noted. “I believe that the greatest public health achievement of the twentieth century was the nineteenth amendment, which gave women the right to vote,” he said. “It actually improved health more than anything else in the twentieth century.”