The Earliest Opportunities Matter
Not All of Minnesota’s Children Have the
Same Healthy Start
At a glance, outcomes for children and families in
Minnesota look good – infant mortality rates are
low, fourth grade reading scores are high,
participation in social programs and services are on
par with many other states. However, these overall
positive scores mask significant health disparities.1
Studies of Minnesota children under the age of
three consistently show that measures for American
Indian children and children of color lag behind
those of white children in areas such as prenatal
care, poverty, birth weight, infant mortality, child
welfare participation, well child visits, and other
measures of well-being.2,3
Brain Development
Neuroscience and behavioral research confirm that
the foundation for future relationships, health, and
the capacity to learn and thrive throughout life
begins before birth and is influenced strongly
prenatally and during the first three years of life.
During the first 1000 days of life, the brain is
developing and forming neural pathways at the
most rapid rate of a person’s life course. Our
earliest experiences and environment actually shape
the architecture of the brain. Because it is the basic
relationship between caregiver and child that shape
experience and environment for a very young child,
relationships are the supporting structure for the
developing brain.4
Commissioner’s Office
625 Robert Street North
P.O. Box 64975
St. Paul, MN 5164-0975
651-201-4989
http://www.health.state.mn.us
The opposite is also true. Research into adverse
childhood experiences, trauma, and toxic stress for
infants and toddlers also shows that these adverse
experiences can negatively influence health,
economic, and educational success throughout the
life course.5,6 In addition, disparities that begin in
childhood are often passed on to the next
generation.
Beyond Biology: Creating the Opportunity
to be Healthy
Health is a state of complete physical, social, and
mental well-being and not merely the absence of
disease or infirmity.7 Health is created in the
community through social, economic and
environmental factors as well as individual
behaviors and biology. These factors – also termed
social determinants of health – include economic
stability and poverty, housing stability, food
security, transportation choices, levels of education,
etc. Research has shown that negative impacts
caused by social determinants of health often
interfere with a parent’s ability to form or continue
positive, nurturing relationships with their
children.8
Minnesota has disparities in child health outcomes
because the opportunity to be healthy is not equally
available for everyone in the state. The opportunity
to be involved in a safe, stable, nurturing
relationship with a parent or caregiver is not
equally available for each child in our state. The
opportunities or lack of opportunities created
through the impact of social determinants of health
are significant drivers for how families and
communities are able to offer social, emotional, and
cognitive support to their babies and young
children.
1
Minnesota Department of Health (2014). Advancing Health Equity in
Minnesota: Report to the Legislature. Retrieved from
http://www.health.state.mn.us/divs/chs/healthequity/ahe_leg_report_02
0414.pdf
2
Chase, R. and Valarose, J. (2012). American Indian Babies in
Minnesota. Retrieved from http://www.wilder.org/WilderResearch/Publications/Studies/American Indian Babies in
Minnesota/American Indian Babies in Minnesota.pdf
3
Chase, R. and Valarose, J. (2011). African American Babies in
Minneapolis and St. Paul. Retrieved from
http://www.wilder.org/Wilder-Research/Publications/Studies/AfricanAmerican Babies/African-American Babies in Minneapolis and St.
Paul.pdf
4
National Scientific Council on the Developing Child (2004). Young
Children Develop in an Environment of Relationships: Working Paper
No. 1. Retrieved from http://www.developingchild.harvard.edu
5
Middlebrooks JS, Audage NC. (2008). The Effects of Childhood
Stress on Health Across the Lifespan. Atlanta (GA): Centers for
Disease Control and Prevention, National Center for Injury Prevention
and Control.
6
Sroufe, L. A., Egeland, B., Carlson, E., & Collins, W. A. (2005). The
Development of the Person: The Minnesota Study of Risk and
Adaptation from Birth to Adulthood. New York: Guilford Publications.
7 The World Health Organization .http://www.who.int/
8
National Research Council and Institute of Medicine (2000). From
Neurons to Neighborhoods: The Science of Early Childood
Development. Jack P. Shonkoff and Deborah A. Phillips, eds.
Washington, D.C.: National Academy Press
Minnesota Babies at Birth
On average, there were 71,700 babies born each
year in Minnesota between 2006 and 2010. Of
those babies, most began a positive and successful
trajectory into early childhood and beyond. A
small percentage of those babies did not have that
same experience.
Infants and Toddlers in Poverty
(Children 0-36 months living at or below 100%
Federal Poverty Guidelines 2009-2011)9
African American
49%
American Indian
55%
Asian/Pacific Islander
21%
Hispanic
37%
White
11%
All
18%
Mothers Receiving Prenatal Care
(Within the first trimester 2006-2010)
African American
Foreign Born African American
American Indian
Asian
Hispanic
White
73%
75%
63%
79%
73%
89%
Preterm Births
(Babies born at less than 37 weeks gestational
age 2006-2010)
African American
15%
Foreign Born African American
9%
American Indian
13%
Asian
10%
Hispanic
10%
White
10%
Low Birth Weight
(Babies born at less than 2500 grams or
5.5 pounds 2006-2010)
African American
Foreign Born African American
American Indian
Asian
Hispanic
White
14%
7%
7%
8%
6%
6%
Teen Birth Rates
(Rates 2006-2010)
African American*
American Indian
Asian
Hispanic
White
*includes Foreign Born African American
9
7%
9%
4%
9%
2%
IPUMS microdata version of the U.S. Census Bureau, 2009-2011
American Community Survey. Tabulations by the MN State
Demographic Center.
Infant Mortality
(Rates per 1000 births 2006-2010)
African American
Foreign Born African American
American Indian
Asian
Hispanic
White
12.5
6.5
9.1
4.9
4.8
4.4
Housing10
(Infants and toddlers 0-36 months living in
households that spend more than 30 percent of their
income on housing costs 2009-2010)
African American
73%
Foreign Born African American
55%
American Indian
48%
Asian
32%
Hispanic
49%
White
32%
*Wilder Research 2012
Maltreatment
(Percentages of all infants and toddlers 0-36 months
Involved with a report of abuse or neglect 2010)11
African American
4%
American Indian
14%
Asian
1%
Hispanic12
not available
White
2%
All
3%
Postpartum Depression
(New mothers who report frequent
postpartum depressive symptoms 2009-2010)
African American
Foreign Born African American
American Indian
Other Race
Hispanic
White
15%
13%
21%
6%
14%
9%
Research and experience tells us that babies facing the
above disparities are most likely to be the same babies
who will experience developmental difficulties, will not
be ready for kindergarten and will not be reading well by
third grade. The families of these children will most
likely experience needs for cash assistance (MFIP and
CCAP), medical (MA) and nutrition assistance (WIC) as
well as intergenerational mental health and home visiting
services.
10
Chase, R. and Valarose, J. (2012). American Indian Babies in
Minnesota. Retrieved from http://www.wilder.org/WilderResearch/Publications/Studies/American Indian Babies in
Minnesota/American Indian Babies in Minnesota.pdf
11
Percentages are estimates based on the population estimates from the
American Community Survey from the State of Minnesota
Demographer’s Office and data from the Minnesota Department of
Human Services. Numerator=Number of 0-36 month old children
reported for abuse and neglect by race/ethnicity (DHS). Denominator=
Number of 0-36 month old children by race/ethnicity (ACS).
12
Due to data collection issues, Hispanic ethnicity not able to be
formulated for this indicator