Health inequities in the Twin Cities region: How our changing economy may influence future health outcomes

Using life expectancy and mortality rates and proxy measures of health, we demonstrated health inequities, related to income and race, persist in the Twin Cities region of Minnesota (Minneapolis/St. Paul and surrounding suburban cities). Using data from death certificates and demographic information from the U.S. Census and American Community Survey, we found relationships between measures of neighborhood wealth (median household income and concentration of poverty) and health. These social gradients, which show health outcomes are better for residents in wealthier communities. In addition, we found racial health inequities persist in the region across all income levels. When we explored how life expectancy rates have changed over time, we found some indication that the gap between health outcomes for residents of our regions wealthiest and poorest neighborhoods may be narrowing. However, recent economic and demographic shifts in the region threaten gains made and pose challenges to sustaining statewide efforts to reduce health inequities. We demonstrate how GIS mapping can be used to target interventions to communities with greatest needs and offer examples of local programs and initiatives that focus on reducing health inequities by implementing interventions that address the barriers to healthy eating and physical activity in lower-income communities.