Context: For many years, the Minnesota Department of Health (MDH) has been intentionally engaged in decreasing race- and ethnicity-based health disparities in the state. It has seen modest success in some areas, but overall, the disparities remain. Research over the last several decades has shown that race- and ethnicity-based health disparities are the result of persistent social and economic inequities, which have a greater influence on health outcomes than either individual choices or interventions by the health care system.
Setting: The MDH leaders recognized that to focus health improvement efforts solely on access to health care and individual behavior change (the traditional public health approaches of the last 30 years) would fail to make adequate advances in eliminating health disparities. Working with a statewide group known as the Healthy Minnesota Partnership, MDH decided to shift the public conversations about health in Minnesota to focus on the factors that actually create health.
Conclusions: This effort to develop and implement a new narrative about health, focused on upstream issues such as education, employment, and home ownership, led to an emphasis on health in all policies approach for MDH and its partners. This case example will highlight Minnesota's efforts and discuss the new Council on Institutional Collaboration initiative in partnering large research universities with state health departments in addressing the social determinants of health.