Grant from the Centers for Disease Control and Prevention (CDC) for Racial and Ethnic Approaches to Community Health (REACH) - REIA
Section 1: Background
| Public Safety | No |
| Housing | No |
| Economic Development | No |
| Public Services | No |
| Environmental Justice | No |
| Built Environment & Transportation | No |
| Public Health | Yes |
| Arts & Culture | No |
| Workforce | No |
| Spending | No |
| Data | No |
| Community Engagement | Yes |
This two-year grant aims to improve health, prevent chronic diseases, and reduce health disparities among racial and ethnic populations with the highest risk, or burden, of chronic disease, specifically the Black (African American, East African) population and the Native American population in Minneapolis. It also aims to reduce and manage COVID-19/flu among Minneapolis residents and visitors, with a focus on African American, American Indian, Latinx, Asian, and Somali communities.
Reducing and Preventing Chronic Conditions: The Health Department (MHD) and its community partners will work together to reduce chronic disease risk factors and prevalence in the African American/East African and Native American populations by implementing strategies that reach individuals and families through subsidized housing and through culturally based organizations. With each community, MHD and its partners will combine a people-approach (supporting individuals through education and engagement) with a place-approach (creating environments that foster good health). Specifically, MHD and its partners hope to achieve the following outcomes: 1) Nutrition: An increase in the number of multi-unit housing properties and community agencies with new or expanded opportunities for healthy food access and an increase in the number of residents who have improved access to healthy food. 2) Community-clinic linkages: An increase in use of onsite and community-based programs and services by the populations of focus.
Supporting COVID-19/Flu vaccination efforts: MHD and its community partners will work together to 1) Support community partners working with racial/ethnic populations to ensure that adequate COVID-19/flu information and services are being provided to these communities, and 2) Increase Flu and COVID vaccination opportunities in communities disparately impacted by COVID-19. Through this work, MHD and its partners hope to achieve the following outcomes: 1) decrease barriers to vaccination through education and engagement with community members, and 2) increase vaccination rates amongst communities most impacted by COVID-19.
Reducing and Preventing Chronic Conditions: The Health Department (MHD) and its community partners will work together to reduce chronic disease risk factors and prevalence in the African American/East African and Native American populations by implementing strategies that reach individuals and families through subsidized housing and through culturally based organizations. With each community, MHD and its partners will combine a people-approach (supporting individuals through education and engagement) with a place-approach (creating environments that foster good health). Specifically, MHD and its partners hope to achieve the following outcomes: 1) Nutrition: An increase in the number of multi-unit housing properties and community agencies with new or expanded opportunities for healthy food access and an increase in the number of residents who have improved access to healthy food. 2) Community-clinic linkages: An increase in use of onsite and community-based programs and services by the populations of focus.
Supporting COVID-19/Flu vaccination efforts: MHD and its community partners will work together to 1) Support community partners working with racial/ethnic populations to ensure that adequate COVID-19/flu information and services are being provided to these communities, and 2) Increase Flu and COVID vaccination opportunities in communities disparately impacted by COVID-19. Through this work, MHD and its partners hope to achieve the following outcomes: 1) decrease barriers to vaccination through education and engagement with community members, and 2) increase vaccination rates amongst communities most impacted by COVID-19.
Luisa Pessoa- Brandão, Director, Public Health Initiatives
Kristen Klingler, Senior Public Health Specialist
Kristen Klingler, Senior Public Health Specialist
Section 2: Data
Instead of targeting specific geographies, the REACH grant will focus on racial/ethnic populations most impacted by chronic disease and COVID-19/Flu: African American, East African, American Indian, Latinx, and Asian communities in Minneapolis.
Minneapolis’ 13,381 Native American residents are widely dispersed across the city, which has an overall poverty rate of 21%. In contrast, due to segregation, 79% of African American/Black residents (or 58,921 of 74,648) are concentrated in the 37 Minneapolis neighborhoods with rates of poverty 20% or higher. These neighborhoods also coincide with the five zip code areas with the highest burden of chronic diseases based on emergency department admissions. In this context, MHD and its partners will leverage the REACH grant to reduce chronic disease in these two priority populations.
To ensure that vaccination clinics will reach the targeted communities, efforts will be focused on 5 zipcodes where a majority of residents are from the priority racial/ethnic communities (55404, 55407, 55411, 55412, and 55454), however all events will be publicized to all city residents.
Minneapolis’ 13,381 Native American residents are widely dispersed across the city, which has an overall poverty rate of 21%. In contrast, due to segregation, 79% of African American/Black residents (or 58,921 of 74,648) are concentrated in the 37 Minneapolis neighborhoods with rates of poverty 20% or higher. These neighborhoods also coincide with the five zip code areas with the highest burden of chronic diseases based on emergency department admissions. In this context, MHD and its partners will leverage the REACH grant to reduce chronic disease in these two priority populations.
To ensure that vaccination clinics will reach the targeted communities, efforts will be focused on 5 zipcodes where a majority of residents are from the priority racial/ethnic communities (55404, 55407, 55411, 55412, and 55454), however all events will be publicized to all city residents.
Minneapolis is generally ranked as one of the healthiest cities in the U.S. However, measures of well-being obscure significant socioeconomic and health disparities both locally and statewide, with racial inequities between white and black Minnesotans among the worst in the country. According to Hennepin County’s 2017 Community Health Assessment, which includes Minneapolis, the five-year age-adjusted premature death rate (under age 65) from all causes is nearly four times higher among American Indian/Alaska Native residents in Minneapolis (681 per 100,000) and nearly two times higher among black or African American residents (329 per 100,000) than among white residents (173 per 100,000). Death rates from heart disease in Minneapolis are 1.5 times higher among American Indian residents and 1.2 times higher among African American residents than among white residents. Furthermore, Minnesota Vital Records data indicate that these two populations have the highest rates of death from chronic conditions, including heart disease, stroke, essential hypertension and diabetes.
As a relatively recent immigrant groups, many Somali residents are unfamiliar with the American health care system and the notion of prevention; this is compounded by language challenges. According to MN Community Measurement’s 2016 Health Equity of Care report, Somali residents generally had lower screening and care rates compared to other preferred language groups and generally worse health outcomes.
Though tribally-diverse, Minneapolis’ Native American population shares common health and related socio-economic challenges. Statewide obesity data reveal that over 25% of WIC-enrolled Native children were overweight by their second year of life. Between ages two and five, the problem worsens as 23% were overweight and 28% were obese.
Minneapolis BIPOC communities have been disproportionally impacted by COVID-19 with hospitalization rates being five times higher for Native American, Black, and Latinx residents compared to white residents, in spite of infection rates being 1.5 times higher among these communities.
As a relatively recent immigrant groups, many Somali residents are unfamiliar with the American health care system and the notion of prevention; this is compounded by language challenges. According to MN Community Measurement’s 2016 Health Equity of Care report, Somali residents generally had lower screening and care rates compared to other preferred language groups and generally worse health outcomes.
Though tribally-diverse, Minneapolis’ Native American population shares common health and related socio-economic challenges. Statewide obesity data reveal that over 25% of WIC-enrolled Native children were overweight by their second year of life. Between ages two and five, the problem worsens as 23% were overweight and 28% were obese.
Minneapolis BIPOC communities have been disproportionally impacted by COVID-19 with hospitalization rates being five times higher for Native American, Black, and Latinx residents compared to white residents, in spite of infection rates being 1.5 times higher among these communities.
While chronic disease outcome data (e.g. obesity, diabetes rates) are readily available for these two priority populations, health behavior data are less so (e.g fruit and vegetable consumption, % of people participating in diabetes management activities, etc). This data is often difficult to obtain, but through the REACH grant we will work with community partners to gather relevant information through community needs assessments, self-report surveys of residents, focus groups, and key informant interviews with community partners. This data will be used to inform the selection of specific nutrition and community-clinic linkage strategies in each priority population.
While we have information on COVID vaccination numbers, we currently do not have the same data on flu vaccination. Additionally, the way race/ethnicity is collected makes it challenging to differentiate between African American and Somali populations so we are making efforts to gather better data through our vaccination events.
While we have information on COVID vaccination numbers, we currently do not have the same data on flu vaccination. Additionally, the way race/ethnicity is collected makes it challenging to differentiate between African American and Somali populations so we are making efforts to gather better data through our vaccination events.
Section 3: Community Engagement
| Inform | Yes |
| Consult | Yes |
| Involve | Yes |
| Collaborate | Yes |
| Empower | Yes |
The Minneapolis Health Department is rooted in transferring knowledge and power to communities through developing leaders and infusing community voices and core values into local health policies, systems and environmental changes. We strive to authentically engage those most impacted by health inequities in the planning, implementation, and evaluation of public health interventions and to let community voices guide our project direction and outcomes.
Currently, MHD actively participates and partners with community-based organizations and groups that are aligned with its proposed REACH strategies. For example, in the nutrition arena, MHD participates on the Northside Fresh Coalition, a coalition of individuals, businesses, and organizations that use food as a pathway toward community well-being, economic and social justice; the Minneapolis Food Council, which sets a policy framework for changing the city’s food environment. MHD has been an active participant in the Twin Cities United Way’s Healthy Communities Task Force focused on expanding use and reimbursement of community health workers. When developing the initial REACH grant application, we hosted planning conversations with potential community partners to learn about their community-speciifc needs, gaps, opportunities, interests, and capacities. The Metro Urban Indian Directors, a coalition of education, social service, and health leaders who engage in joint planning and service delivery on behalf of the Native urban population, jointly designed the REACH strategies with MHD based on their collective visions, cultural practices, and collective abilities to engage the Native American population. Ideas, stories, and lessons learned from these existing relationships and collaborations helped inform the REACH grant application and will continue to guide future planning and implementation efforts.
Over the COVID pandemic MHD has engaged with community partners to both provide information and get feedback and information how to best serve the communities most impacted by COVID. This work has continued in relation to vaccination in order to build capacity of trusted messengers and ensure that vaccination events are publicized within the communities we are intending to reach.
Going forward, we will continue to engage with the priority communities through a variety of mechanisms including community conversations, listening sessions, visioning sessions, and leadership positions. Through these engagement strategies, people in each population will tailor the REACH strategies to meet their needs and cultural considerations.
Currently, MHD actively participates and partners with community-based organizations and groups that are aligned with its proposed REACH strategies. For example, in the nutrition arena, MHD participates on the Northside Fresh Coalition, a coalition of individuals, businesses, and organizations that use food as a pathway toward community well-being, economic and social justice; the Minneapolis Food Council, which sets a policy framework for changing the city’s food environment. MHD has been an active participant in the Twin Cities United Way’s Healthy Communities Task Force focused on expanding use and reimbursement of community health workers. When developing the initial REACH grant application, we hosted planning conversations with potential community partners to learn about their community-speciifc needs, gaps, opportunities, interests, and capacities. The Metro Urban Indian Directors, a coalition of education, social service, and health leaders who engage in joint planning and service delivery on behalf of the Native urban population, jointly designed the REACH strategies with MHD based on their collective visions, cultural practices, and collective abilities to engage the Native American population. Ideas, stories, and lessons learned from these existing relationships and collaborations helped inform the REACH grant application and will continue to guide future planning and implementation efforts.
Over the COVID pandemic MHD has engaged with community partners to both provide information and get feedback and information how to best serve the communities most impacted by COVID. This work has continued in relation to vaccination in order to build capacity of trusted messengers and ensure that vaccination events are publicized within the communities we are intending to reach.
Going forward, we will continue to engage with the priority communities through a variety of mechanisms including community conversations, listening sessions, visioning sessions, and leadership positions. Through these engagement strategies, people in each population will tailor the REACH strategies to meet their needs and cultural considerations.
Section 4: Analysis
MHD and its partners will leverage the REACH grant to reduce chronic disease and COVID/Flu disparities among specific racial and ethnic communities. Through the REACH grant, we will work with community partners and those most impacted to implement a variety of policies, programs, and services to improve immediate and long-term individual and population health outcomes.
Section 5: Evaluation
MHD staff will designate a portion of the REACH funding for staff and partners to focus on process, impact, and outcome evaluation of grant-funded strategies. We will report on evaluation results, successes, and lessons learned at the end of the grant period, as required.
Chronic conditions performance measures:
1) Number of places with new or improved access to nutritious, affordable, culturally relevant foods
2) Number of people who have access to the above resources
3) Number of places with new or improved access to evidence-based health programs and services
4) Number of people who enroll in/utilize the above resources
COVID/Flu performance measures:
1) Number of trusted messengers trained
2) Number of vaccination events hosted
3) Number of vaccine doses provided
Chronic conditions performance measures:
1) Number of places with new or improved access to nutritious, affordable, culturally relevant foods
2) Number of people who have access to the above resources
3) Number of places with new or improved access to evidence-based health programs and services
4) Number of people who enroll in/utilize the above resources
COVID/Flu performance measures:
1) Number of trusted messengers trained
2) Number of vaccination events hosted
3) Number of vaccine doses provided
Ongoing engagement with the priority populations and project partners is a high priority for MHD.
Throughout the two year REACH grant, we will provide information and share progress in a variety of ways including:
1) Share back a summary of any health assessment results (e.g. food environment assessment, resident listening sessions re: chronic disease prevention service needs).
2) Seek resident input to inform the identification, prioritization, and selection of specific REACH strategies.
3) Share annual reports, lessons learned, success stories, and other progress reports with project partners.
4) Provide progress reports and highlight key outcomes in partner newsletter articles, at partner meetings, and through other informal communications channels that reach members of the priority populations.
5) Information on the success of vaccination events will be shared with partners after each event. MHD will continue to monitor vaccination rates among communities of interest and share back; lessons learned from engagement will be shared with both community partners and MHD staff.
Throughout the two year REACH grant, we will provide information and share progress in a variety of ways including:
1) Share back a summary of any health assessment results (e.g. food environment assessment, resident listening sessions re: chronic disease prevention service needs).
2) Seek resident input to inform the identification, prioritization, and selection of specific REACH strategies.
3) Share annual reports, lessons learned, success stories, and other progress reports with project partners.
4) Provide progress reports and highlight key outcomes in partner newsletter articles, at partner meetings, and through other informal communications channels that reach members of the priority populations.
5) Information on the success of vaccination events will be shared with partners after each event. MHD will continue to monitor vaccination rates among communities of interest and share back; lessons learned from engagement will be shared with both community partners and MHD staff.