There are no Magic Bullets

If there is one thing that my Introduction to Global Health class taught me, it is that there are no magic public healthcare policy bullets. We simply cannot isolate issues to identify micro-solutions sufficient to overcome large scale, sytemic challenges.

Minnesota, compared to the rest of the United States, has an exceptional health care system. According to the United Health Foundation, Minnesota’s health care system ranks number three, with our strengths being a low prevalence of physical inactivity and diabetes, a strong high school graduation rate, and low rates of premature death and cardiovascular disease deaths. However, MPR’s recent reports that investigate Minnesota health disparities are revealing a disturbing trend. Marginalized individuals have higher rates of health discrepancies. This marginalization threatens the whole.

Marginalized Minnesotans' health disparities aren’t simply due to poor health care access although that certainly can play a role. Health disparities are often linked to external factors such as stress faced by discrimination, the proximity of one’s home to an interstate, and the home's condition.

Many, if not all, of our lifestyle choices impact our health. If we choose to smoke, we put ourselves at a higher risk for lung cancer. If we drink excessively, we put ourselves at a higher risk for liver damage. However, do we want to accept a Minnesota that allows for marginalized individuals to face higher health care costs for a lifestyle they do not choose but is forced upon by economic status?

Consider long-term health care cost to society. Kids going to the hospital for an asthma attack due to home location to hospital bills that the family may or may not be able to afford, undermining family economic stability. It also reduces the hospital space for people who endure non-preventable emergencies. A society ruled by stress, a notable health issue in the LGBTQ community, only increases our nation’s mental health epidemic and affects our society’s ability to be as productive, and happy, as we can be.

Resolving and improving these challenges won't be easy. There is no magic bullet. We can’t focus on health care and expect it to improve drastically just as we can’t simply focus on housing development or education. We can't lose sight of the big picture in our world of specialization. Seeing the forest is just as important as seeing each tree.

Posted in Health Care | Related Topics: Health Care Reform  Public Health 

Good Jobs, Bad Jobs Reports for Clearwater County, Rural Minnesota

The Minnesota county with the highest unemployment rate in June also saw the greatest month-to-month improvement among Minnesota's 87 counties.

Clearwater County, in northwest Minnesota, had a full one percent drop in the official unemployment rate from May with unemployment falling to 9.5 percent in June from 10.5 percent in May and and from a painfully high 14 percent as recent as April.

The Minnesota Department of Employment and Economic Development (DEED) released June unemployment data for counties on Tuesday, July 22. Statewide, Minnesota is among the Top Ten states for low unemployment, at 4.5 percent, but the extremes of both high and low unemployment continue to be localized in counties far from the Twin Cities metro area.

Tom Burford, manager of the Farmers Publishing Co. community cooperative and editor of its Farmers Independent newspaper at Bagley, said he suspects the statistical improvement in the county unemployment rate reflects a return to more "normal" employment in June. "We really had awful spring weather," he said.

A few firms, such as component parts engineering and manufacturing company Team Industries at Bagley, have added jobs, he said. At the same time, no new factories or new businesses have opened in the county and started hiring in June.

Clay County is the Minnesota side of the Fargo-Moorhead metro area. It had the lowest unemployment rates in June at 2.8 percent. Stevens County, which had a statewide low of 2.6 percent unemployment rate in May, had its June rate bump to 3.0 percent.

The Canadian border county of Koochiching, meanwhile, saw June unemployment increase a tick to 9.2 percent, from 9.1percent in May, to join Clearwater County on the high end of the unemployment list.

Except for Clay, statistical measures of employment and unemployment are influenced by thin numbers in demographic information in several rural counties. Clearwater County, with five incorporated cities that are all small towns, had only 8,695 residents in the 2010 Census. County seat Bagley, the county's largest city, had a population of 1,392.

As Burford noted, it doesn't take a huge number of jobs gained or lost to impact the unemployment rate in densely populated counties. Going forward, however, it will take jobs creation and higher paying jobs to lift people out of poverty and get unemployed people back into the jobs market.

Posted in Economic Development | Related Topics: Job Growth  Unemployment  Rural Minnesota 

Game-Based Ed Gains XP

Say the word “game” to someone and their first thought might be of a frivolous (perhaps even trivial) pursuit. However, effectively merging the best of games with education offers real potential for increasing learning and personal development in many areas.

The Atlantic has covered some of the leaders in bringing game-based learning to higher education. Notoriously slow to change its pedagogy, college and university learning is dominated by the lecture approach that too often bores students and proves less effective than desired in helping them learn. A few professors have applied the principles of game design—narratives, quests, collaborative guilds, experience points (XP), etc.—to their classrooms, and have seen increases in attendance, engagement, and performance.

The use of gamification isn’t limited to the college level. Perhaps the most widely known gaming-and-learning Minnesota educator is White Bear Lake elementary teacher Ananth Pai. He has put significant time and personal resources into using technology-supported games to help K-12 students learn better. The results have been impressive.

In higher education and the K-12 environment, the benefits of games reach far beyond test scores. The effects of well-designed gamification support collaboration, persistence, and problem solving, along with many other tough-to-measure areas. Gaming at home, whether with classics like chess or newer games like Set or Quarto (both of which have been around for years, but which are still new in comparison to chess), has also been shown to help children build executive function, strategic thinking, concentration, and impulse control, among other areas.

As with all innovations—especially where technology is involved—the use of game-based education shouldn’t be enforced by top-down mandates. Instead, it relies on teachers putting the time and effort into changing the way they teach to use gaming principles effectively. They should be supported in this effort. Teachers who have already had success would make good candidates for local, teacher-led professional development for other interested teachers.

There is a lot of good to be reaped from integrating games and education, and teachers who are interested in doing so should have the flexibility, trust, and support they need to make it happen.

Posted in Education | Related Topics: Higher Education  K-12 education  Classroom Methods  Curriculum 

Community Collaboration Helps Shape Policy

Public policy shapes and regulates our country, states, and municipalities but it can also strengthen and empower communities. Unfortunately, policy is too often created without enough (or any) input from those it affects. To change this typical top-down implementation framework, communities must organize their members to help fight for policies that they, collectively, are passionate about and will benefit from.

The Twin Cities Labor Chorus at the East Side Freedom Library

Minnesota is home to many unique communities—towns, neighborhoods, cultural communities, and others—that each face their own obstacles when trying to bring people together. Some communities experience large variation in ages, ethnicities, countries of origin, and languages, and these differences should be celebrated. While such celebration doesn’t always come easily, one way to help connect people is by sharing personal narratives, which help people empathize and create movements that win the policies that can help all different members.

My recent tour of the East Side Freedom Library opened my eyes to the necessity of community ties and collaboration. Formerly the community's St Paul branch library, one of three historic Carnegie libraries, it has been reinvented as a community space where members of the community can share their stories and research the area’s rich history. Peter Rachleff, the president and project visionary, shared with me his ideas of the many ways (plays, paintings, sculpture, readings, etc) people could tell their stories.

This combination of storytelling and historical research helps neighbors connect with and understand those around them, despite any barriers. These established connections can lead to further discussions and understanding, helping a group of people come together because of their differences to help change things for the better.

This type of hyper-localized community building is just one of many examples around the state. Others include: community centers run by local parks and rec boards and resident volunteers, schools that directly involve parents in their children’s education, and community gardens.

Too often people become disconnected from their neighbors, their town, or their city, and what they need is a connecting force or institution to bring them together. Public policy that builds these connections creates a feedback loop, empowering people to take control and shape future policies that affect their communities. We should expect more public policy to make stronger and more supportive communities where hopefully all people, no matter their differences, will benefit and thrive.

Posted in Economic Development | Related Topics: Libraries  Progressive Community 

Fix the Green Line Slowdown

Given that the average rider's trip on the new light rail Green Line is just 3 miles long, its slower than expected travel times between the Minneapolis and St. Paul downtowns shouldn't discourage patronage much. In fact, weekday ridership is already 10 percent above projections for next year, even before a likely boost once fall classes start at the University of Minnesota campus bisected by the tracks.

Metro Transit officials have said all along that if you want a quick trip the length of the Green Line's route, take the 94 Flyer bus down the freeway. The light rail is designed more for shorter connections to the many busy nodes between the downtowns.

But one impact of the Green Line slowdown—sometimes clocking well more than 20 minutes over the 40-minute end-to-end timetable originally estimated, according to the Star Tribune—should be a concern. That's the added cost of putting more trains on the line in an effort to keep closer to the posted schedule. According to Frederick Melo in the Pioneer Press, that could inflate the service's $35 million annual gross operating budget, already a sore point with transit-bashing conservatives.

Trains often being forced to wait at 46 traffic signals in St. Paul has been blamed for the delays. City officials have rejected giving the light rail signal preemption such as the Blue Line enjoys along Hiawatha Avenue in Minneapolis. "That is just seriously bad engineering," UofM Prof. David Levinson told the Strib. "If you are serious about transit and encouraging people to take transit, you need to make it as efficient as possible."

Former Metro Transit planner Aaron Issacs has suggested a sensible compromise on—give the trains full signal preemption at 19 intersections along University Avenue where combined car-light rail traffic is 3 to 8 times greater than that on the cross streets. 

"It is hard to rationalize a train with 300 people stopping at an intersection with no cross traffic," Metro Transit chief Brian Lamb said in a statement quoted in the Pioneer Press.

So far, city officials say giving the Green Line the green light anywhere would unduly disadvantage drivers, pedestrians and bicyclists trying to cross the tracks. They contend that fine-tuning a signal system that is supposed to give the trains partial priority can solve the problem. According to Isaacs, however, "There are simply too many traffic lights spaced too close together for conventional signal timing with priority to move the trains along."

I live in the Longfellow neighborhood of Minneapolis and often drive across Hiawatha and the Blue Line tracks. Sometimes I get delayed a few seconds by the trains. Big whoop. If St. Paul leaders want to reap the full benefits of the Green Line's game-changing transit improvement, they should do more to help it operate efficiently and economically.

Photo from Metro Transit, Flikr

Posted in Transportation | Related Topics: Public Transportation  Central Corridor 

Life-Saving Legislation: A New Law to Prevent Heroin Overdose Deaths

With more and more fatalities each year, heroin overdose has become a statewide epidemic. Minnesota’s heroin-related deaths in 2013 almost doubled from 2011 and the upward trend continues.

Addressing this problem, Minnesota's state policymakers created and passed life-saving legislation. Thanks to a law that takes effect this month, those who seek medical help for a person experiencing a drug overdose are immune from criminal charges, like possession or use of drugs. This protection encourages bystanders to call 911 and save a life, without fear of prosecution.

The Hennepin County Sheriff’s Office is the first department in Minnesota to implement the law’s second component which allows law enforcement to carry and administer an antidote for heroin overdose, starting August 1st.

Licensed physicians must authorize officers to use the drug, which can fully revive an overdose victim if it’s dispensed in time. Aiming to train at least 75 deputies, the Hennepin County program will cost about $12,000. The money will mainly come from the drug forfeiture and seizure fund, according to Sheriff Rich Stanek, quoted in a Minnesota Public Radio story.

Counties across the state are keeping an eye on the outcomes of Hennepin's new policy to determine a course of action. But as departments delay medical authorization, officer training, and resource management, lives are at risk.

When police in Hennepin County (and hopefully the rest of Minnesota) implement specific techniques to save lives from heroin overdose, the whole population benefits from community-centered law enforcement. With more tools and training programs like this one, police could soon find methods to cope with other challenges, such as mental health, street harassment, or additional substance abuse issues.

Minnesota lawmakers made incredible progress with this legislation and Hennepin County is courageously adapting its law enforcement strategies to prioritize people's needs and safety. Now, it is up to the rest of Minnesota's communities to follow suit.

Posted in Health Care | Related Topics: Community Safety  Public Health 

Summer Melt’s Impact on High School Graduates

Many new high school graduates are spending the summer thinking about their fall college plans. College is an enormous shift for recent grads. Between classes, being away from home, and finalizing school financing plans, new, soon-to-be first year college students shoulder considerable anxiety.

For most nervous graduates and their families, however, high school resources are suddenly unavailable to them. Many students struggling with the high school-to-college transition are reluctant to approach their new school’s staff for fear of ‘making a bad impression." Returning to their high school support system can bridge the gap.

According to an Associated Press investigation, “first-generation college students and low-income families are particularly vulnerable” to this post-grad “summer melt.” In a startling statistic by Harvard’s Center for Education Policy Research, up to 40% of prospective community college students in large metropolitan areas abandon their plans.

As many as half of these students decide not to pursue post-secondary education due to financial concerns. They are, however, making this decision without professional guidance.

What is the solution to this growing problem in Minnesota? Enhance the number of counselors in our schools and extend summer counseling hours for recently graduated seniors.

Minnesota’s counselor shortage is well-documented. In February of this year, the Minnesota School Counselors Association urged Governor Dayton to continue working on Minnesota’s dismal counselor statistics. With one school counselor for every 792 students, Minnesota ranks 48th in the United States.

The press release also cites the fact that counselors offer a unique range of talents that help students. Their role in the school “helps students maximize their academic success, career readiness, and personal and social development.”

This service is crucial to all Minnesota families and reduces many issues facing students and colleges. Having a better understanding of financial aid plans can improve the financial health of students. Knowing what college courses will be like can lead to less time spent in remedial courses and improve retention. Familiarity with academic and procedural deadlines can ease students’ navigation of college bureaucracy.

Counseling is crucial in preparing students for college of any form. After leaving for college, when many students need it more than ever, this already limited resource ends. While not all graduates will take advantage of school counseling resources, many will. While “summer melt” is a real phenomenon, it doesn't have to be a reality for Minnesota’s high school graduates.

Posted in Education | Related Topics: Higher Education  K-12 education 

Let’s Talk About Sex (Well, Power)

Fresh faced, anxious, excited teens head off to college. Their energy fills the campus for the first few weeks. These kids are eager to grow but nervous to fail, unsure if they are truly prepared for what lies ahead. While most students worry about grades, social acceptance, and paying for school, something that typically doesn’t cross their minds looms on the horizon: sexual violence.

We’ve all seen the national headlines. The good news is campus sexual violence crimes are increasingly reported to the police. Minnesota is experiencing a 23% increase of victims reporting sexual assaults. However, despite the increased issue profile and police reports, 1 in 5 women attending a Minnesota higher education institution will be sexually assaulted while in college. The victims are frequently marginalized while perpetrators seem to escape responsibility. Complicating the situation, colleges act as both a police force and adjudicator. A recent New York Times story, like others published across the country, captures the problem's nature. American higher education is riddled with victim-blaming, lacks training and regularly commits procedural errors in dealing with cases.

We cannot stand for this treatment of victims of not only sexual assault, but a system that does not adequately protect them. So why does this happen? And how do we fix it?

Katie Eichele, Director of the Aurora Center, which serves victims, survivors, relatives of victims, and those who are concerned with sexual violence at the University of Minnesota, explains that these cases often arise from a lack of understanding of what sexual assault and rape are, as well as what it means to consent to sex or other intimate activities.

The center operates from an affirmative consent approach, which dictates that only a “yes” means yes: silence is not consent, and "no" does not mean one should pry further. 

Eichele says there are a number of pathways one can take to extinguish this issue. First and foremost there must be early education clarifying what consent, sexual assault, and rape actually mean as well as training that dispels sexual assault myths. Bystander training should also be available. This training has to take place before students step foot on a college campus as more than 40% of victims experienced sexual assault before age 18. Early training creates greater understanding of consent and abuse, leading to social adjustment that changes how institutions and individuals view sexual interactions and sexual assault as well as increasing men's engagement in speaking out against sexual assault. 

More specialized training also needs to be required for anyone dealing with sexual assault cases. This includes but is not limited to medical examiners, first responders, counselors, and police.  Improved and increased comprehensive training reduces misunderstood cues and heighten awareness of signs of sexual assault. 

Victims also must have access to confidential resources to learn more about what it means to file a police report and what options are available to them. As the process of filing reports for sexual assault can be personal, intrusive, and emotionally grueling victims need a support system that has the specialized means to aid them in the proceedings.

Lastly, we have to debunk the notions that rape is about sex and is typically commited by strangers. Rape is about power and nearly all rapes are commited by someone the victim knows, making it more difficult for victims to speak up and act against their perpetrator. And while changing process is easier than changing attitudes, it is an excellent place to start.

There are a slew of issues complicating this problem even further, ranging from how schools punish perpetrators to a victim-punishing slant in our society. However, it doesn't have to stay this way. 

Let's make some noise. Let's talk about how to fix our inadequate system. Let's prove that the arc of the moral universe does in fact bend toward justice.

Posted in Health Care | Related Topics: Higher Education  Racial Inequalities  Community Safety 

2015 Projections Show Success of Progressive Property Tax Reforms

The Minnesota State House of Representatives Research Department recently released two new property tax reports. The first showed that statewide property taxes will decline by $49 million or 0.6 percent from 2013 to 2014—the first statewide property tax reduction in over a decade; this report was examined in a July 21 Minnesota 2020 article. The second report projected that property taxes statewide will increase by 2.8 percent from 2014 to 2015.

Conservatives ignored the first report, but were quick to jump on the second as proof that the 2013 and 2014 property tax reforms were a failure. The Star Tribune quoted former House Tax Committee Chair Greg Davids (R-Preston), “This report proves they [progressive legislators] didn’t keep their word and now Minnesotans are going to pay an even steeper price [i.e., higher property taxes].”

This conservative critique is off target, the product of wishful political thinking. It's a desperate desire to discredit progressive accomplishments made during the 2013 and 2014 legislative sessions.

As House Research staff readily acknowledge, no one knows with certainty what 2015 property taxes will be because local governments have yet to set their levies. Proclamations of the failure of progressive property tax reform based on 2015 projections are at best premature. Nonetheless, the new House Research simulation represents the most informed guess on 2015 property tax levels currently available and they should not be dismissed out of hand.

If we assume that the 2015 House Research projection is reasonably accurate (at least on a statewide basis), what does it tell us about the success or failure of progressive tax reforms? The projected 2.8 percent statewide property tax increase includes taxes on new construction—including new homes and businesses that were built and improvements to existing properties that were made. Obviously, if a new structure is constructed on a vacant lot, the tax on the property will increase.

To gauge the tax increase on properties that underwent no year-to-year improvements that drive up property value, it is necessary to exclude new construction from the projected 2015 total tax. Excluding new construction, statewide property taxes are projected to increase by 1.6 percent in 2015, which is less than the projected rate of inflation for 2015.

Progressives never promised that the reforms enacted over the last two years will prevent all future property tax increases, just as private businesses never promise to prevent all increases in the cost of bread, refrigerators, gasoline, or housing. Inflation drives up the cost of goods and services over time—both public and private.

Conservatives appear to argue that any property tax increase proves that progressive property tax reforms were a failure. This is not only unrealistic but it is a standard that conservatives never applied to their own tax policies. For example, during the tenure of Governor Pawlenty when a conservative agenda dominated state fiscal policy, the average annual growth in statewide property taxes excluding new construction was 4.4 percent—significantly greater than the annual rate of inflation over these years and nearly three times greater than the 1.6 percent increase projected for 2015. Yet, not a critical peep from conservative policymakers.

If the House Research 2015 property tax projection is accurate, it shows that the progressive tax reforms enacted over the last two years are succeeding in holding tax growth on existing property at or below the rate of inflation. This is something that conservatives failed to accomplish when they controlled state government, despite all their “no new tax” rhetoric. Minnesotans must decide whether they prefer the sub-inflationary property tax increases resulting from progressive tax policy or the super-inflationary increases wrought by conservatives.

Posted in Fiscal Policy | Related Topics: Property Tax 

Climate Change as an Economic Threat

Last Thursday, Governor Dayton charged Minnesota to eliminate coal from the state’s energy production. This aspiration is not only rooted in environmental concern; climate change poses a serious economic threat to the state. Reducing greenhouse gas emissions is the smartest business strategy to lessen the risk.

The Midwest faces a daunting financial future if we do not shrink our carbon footprint. According to a June report by The Risky Business Project, midwest agriculture is especially vulnerable. If no progress is made to slow rising temperatures, the entire region could face a decline of up to 63% in its crop yield by the end of the century.

Farmers can accommodate climate change with strategies like double-and-triple cropping, crop rotation, and seed modification but these adaptations come at a high price. Shifting new crops requires expensive new equipment and expertise which often impose economic losses.

Climate change could move agricultural business away from the Midwest to the Upper Great Plains, Northwest, and Canada. “This shift could put individual Midwest farmers and farm communities at risk if production moves to cooler climates,” the report warns.

As greenhouse gases accumulate, heat and humidity threaten Minnesota’s public health and economy. When temperatures of 95 degrees Fahrenheit or higher pair with high humidity, the danger of heat stroke and death increases. Research shows that from 2020 to 2039, Minnesota could see between 3 to 7 days every year with such dangerous temperatures and humidity levels.

With hotter conditions, labor productivity for outdoor workers will plummet. Demand for electricity to fuel air conditioning will increase, and costs for residential and commercial consumers will skyrocket.

By understanding the economic consequences of climate change, businesses and governments can integrate climate-related risks into their decisions on capital expenditures and infrastructure projects.

Governor Dayton’s action against unsustainable energy portrays the sentiment that must be adopted by all policymakers and business owners in order to mitigate climate change. Our economy depends on it.

Posted in Economic Development | Related Topics: Agriculture  Economic Growth  Climate Change 

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