• Residential segregation. Gentrification, urban renewal, and the historical practice of redlining (refusing to lend money to borrowers based upon race or refusing to lend money to purchase housing in an area with a high concentration of minorities) all affect where low-income people of color can live. This, in turn, affects their health.
  • Race and racism. Race interacts with the process of residential segregation and thus cannot be ignored when health outcomes are evaluated.
  • Lack of access to health care. Lack of access, especially for specialty care, is a major problem for people of color living in low-income communities.
  • Lack of community infrastructure. A lack of safe places to walk and exercise and a lack of access to large grocery stores in a community affect the health of the residents in that community. These are important because skyrocketing obesity rates in some racial and ethnic minority groups are contributing to rising rates of chronic diseases, such as diabetes, which can be ameliorated by exercise and a healthy diet.
  • Other community factors. Poverty and violence are major contributors to racial and ethnic health disparities.
  • Shorter life spans for future generations. Several speakers noted that if current trends continue, children born today will not live as long as their parents do. Studies of foreign-born immigrant children and U.S.-born children of immigrant parents indicate that the U.S.-born children will have shorter life spans than their parents.

ORGANIZATION OF THE REPORT

The report that follows summarizes the presentations and discussions that occurred during the workshop.

Chapter 2 reviews the presentation and discussion of the commissioned paper, A Time for Opportunity: Local Solutions to Reduce Inequities in Health and Safety. Chapter 3 describes the efforts made to reduce health disparities at the local level in Minneapolis and at the state level in Minnesota.

Chapter 4 includes a set of introductory comments from Roundtable member Tom Granatir, followed by Annette Williamson’s presentation about efforts in England. Joel Weissman’s observations about the effects of health care reform at the state level follow. Finally, Chapter 5 describes the comments and observations of the reactor panel and the concluding comments of the Roundtable chair, Nicole Lurie.



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