The State We're In

At the Center for Prevention we are funded from the proceeds of Blue Cross’ historical settlement with the commercial tobacco industry, and we use these resources to help fight health inequities in Minnesota. Addressing the harms caused by commercial tobacco is core to our work. While the overall smoking rate in Minnesota has dramatically decreased, commercial tobacco use remains one of the leading causes of death and disease. Marketing of these products continues to cause more destruction for communities of color, American Indians, immigrants and refugees.

Throughout its history, the commercial tobacco industry has been misrepresenting and appropriating American Indian traditions, values and beliefs to market and sell their products. It’s a direct assault on American Indian culture, traditions and practices.

We have had the privilege to work with tribal communities to help reduce harm caused by commercial tobacco, and we are grateful for what we’ve learned along the way. Understanding the difference between commercial tobacco and sacred tobacco is critically important for shifting the dominant narrative around Tribal communities and their health.  In the next three episodes of the State We’re In, we’ll explore how honoring sacred tobacco and cultural traditions can lead to healing for Anishinaabe and Dakota people in Minnesota.

These episodes are inspired by dedicated leaders who are doing this work. Over the summer we’ve had opportunities to have several conversations about sacred tobacco, healing from addiction, and health in Minnesota’s American Indian Communities.

We begin our series with conversations with Chris Matter, Senior Program Manager at Blue Cross and Blue Shield of Minnesota, and CoCo Villaluz, Senior Community Development Manager for ClearWay Minnesota, to get some background on how mainstream organizations and Native American communities are working together to reduce commercial tobacco use.

In part 2 of our series on Sacred Tobacco, we’ll talk about “Tradition versus Addiction” for American Indian tribes in Minnesota.

There are 11 federally recognized tribes in Minnesota, comprised of seven Ojibwe federally recognized reservations, and four Dakota communities,  all with their own sovereign governments: Bois Forte, Fond du Lac, Grand Portage, Leech Lake, Lower Sioux, Mille Lacs, Prairie Island, Red Lake, Shakopee Mdewakanton, Upper Sioux, and White Earth. 

Ojibwe and Dakota people in Minnesota have tobacco traditions that were passed down for generations, for centuries before the arrival of Europeans. Using Native tobacco in a sacred manner is not a health risk. Teaching youth about their power and spirituality allows them to see tobacco differently, as a protective factor against harmful behaviors.

We had the honor to sit down with Sharon Day and Suzanne Nash from the Indigenous People’s Task Force to talk about sacred tobacco traditions that were passed down to them as Ojibwe people, and how they are sharing these practices across generations in their community.

In part 3 of our series on Sacred Tobacco, we’ll talk about “Healing Generations" in the Lower Sioux Indian Community.

Throughout these conversations we’ve learned that “culture is prevention.” Cultural practices and traditions, including the use of sacred tobacco play an essential role in healing and wellness.

We hear from Mat Pendleton, Lower Sioux Youth Recreation Director, reflecting on sacred tobacco traditions that he has learned and shares through his work.

We also hear from Darin M. Prescott, CEO of the Lower Sioux Health Care Center about how traditional practices inform and transform conventional medical practices.

Lastly, we hear from Kara Siegfried, Assistant Tribal Planner/Grant Writer for Lower Sioux, reflecting on the holistic approach to health at Lower Sioux.

Minnesota is one of the healthiest states in the country, but it has some of the worst health disparities.  A primary driver of health and chronic disease starts in people’s social and physical environments. This could be transportation, education, childcare settings, or their housing. All communities can experience poor health outcomes, but due to systemic inequities and the racial hierarchy on which the United States was built., they disproportionately occur in communities of color and the American Indian community.

In this episode we take a closer look at what we mean by “systemic inequities,” and talk with two people deeply engaged in this work in two large health institutions in Minnesota: Vayong Moua, Health Equity Director at Blue Cross, and Maria Sarabia, Racial and Health Equity Administrator at Ramsey County. They both serve on the Cultural and Ethnic Communities Leadership Council in the state of Minnesota’s Department of Human Services (DHS).

DHS is the state’s largest agency and provides or administers a variety of services to help people meet their basic needs and live as independently as possible. The agency makes up approximately 42 percent of state spending and approximately 80 percent of the agency’s $18.65 billion fiscal year 2019 budget is devoted to health care and related services. DHS is working to implement equity practice and capacity within its core functions, through implementing a health equity policy, and the formation of the Cultural and Ethnic Communities Leadership Council, that serves to track equity, accountability, and systems change throughout the agency.

One of the key messages guiding the Center for Prevention’s mission to tackle the leading causes of preventable disease is around the importance of community. A thriving community is made up of people who care for and about each other; people who depend on one another.

The dominant health narrative says that health is about individual choices and behaviors. However, because of inequities built into our systems, policies and environments, not everyone has the opportunity or access to make healthy choices. We need to work together to change the systems and structures that hold us back from our full potential as healthy thriving communities.

In this episode, we invited LaTrisha Vetaw and Jill Chamberlain to have a conversation about the roles of individuals and of community, the importance that lived experiences and seeing yourself as a part of your community play in shifting the narrative around health – especially physical activity, access to healthy spaces such as parks and walking paths. LaTrisha has over a decade of experience serving her community, both as Health Policy and Advocacy Director at NorthPoint Health and Wellness Center and most recently as a Minneapolis Park Commissioner At-Large. Jill is passionate about supporting policy and systems change work around active living, serving as Senior Community Health and Health Equity Program Manager at the Center for Prevention.

Stories surround all of us, and the way they are told shapes how we make decisions in both conscious and unconscious ways. What influences the stories we see and hear?  Whose voices are heard the most and who is being left out?

In this episode we examine these questions through the work of ThreeSixty Journalism, a nonprofit that uses principles of strong writing, reporting and media production to help diverse Minnesota youth tell the stories of their lives and communities.

For the second year in a row, during the summer of 2018, ThreeSixty and the Center for Prevention partnered together to conduct a one-week TV Broadcast Camp for high school students. The theme was health equity, with the goal of inspiring more active participation in creating more equitable, healthier communities. This work illustrates how changing the narrative, who is telling stories and how they are created, is an integral part of this goal.

Minnesota is one of the healthiest states in the U.S., yet we have some of the worst health disparities.

The factors that play the greatest role in these health disparities — race, income and ZIP code — require community-led changes and solutions. It’s changes at this level, through workplaces and policies, along with communitywide change, that will lead to long term, sustained health improvement.

In this special edition of the State We’re In podcast, Anika Ward, Director of the Center for Prevention, has a conversation with her brother, Saint Paul Mayor Melvin Carter, about his leadership in Saint Paul, and the City’s role in the health of its residents. They talk about bringing all voices to the table, especially those who have been excluded, to undo the policies and systems that have created the gaps we see in health, wealth, and education, and what it will take to create healthy and strong communities for generations to come.

The conversation continues with health advocates throughout Minnesota who talk about their different approaches to this work.

In this episode we’re focusing on Trauma and Repair: how trauma threatens health and wellbeing for individuals and communities. It’s an important issue for us at the Center for Prevention, as it feeds into the health disparities we see in Minnesota.  It’s not an exaggeration to say that unaddressed trauma generates lifelong consequences that can end in early death.

We’ll talk with people in Minnesota who are working in their communities to address and prevent trauma, along with rebuilding and healing from trauma, as we consider what it means to be trauma-informed when addressing the health equity in our state.

Understanding the current and historical context in which we all live is a key component to advancing health equity, especially as it relates to historical and collective trauma inflicted on African Americans and indigenous communities. The adverse effects of past violence carried down from generation to generation is known as historical trauma. Collective Trauma happens to large groups of individuals and can be transmitted through generations and across communities.

Collective and historical trauma affects people in countless ways: manifesting in the lack of access to housing, safe spaces and healthy food; community violence; people coping through addictive behaviors like smoking or drug use; and the resulting chronic health conditions that many families and communities face. Addressing root causes means knowing that both racism and oppression are embedded in American culture, and realizing how this, along with massive historical traumas, continue to shape the lives of individual children, families, and communities.

Through the conversations in this episode, we hope to support learning, growth, and understanding of historical and collective trauma, racial justice and how to foster community healing. We had the chance to sit down and talk with a few dedicated individuals who work for this change every day. It’s not quick or easy, and it requires coming together with openness and persistence to shine a light on these issues to create the opportunities for better health for all of us.

In this episode we explore Belonging and Othering, and what it means to belong to a community, to a society, to one another, inspired by the work of John A. Powell from the Haas Institute for a Fair and Inclusive Society, and author of the book Othering and Belonging.

We’ll have frank conversations about what it means to feel ‘othered,’ and the health implications for when systems are created and perpetuated to other groups of people, and how this leads to the serious gaps in access to health and wellbeing in the state of Minnesota. And what we can do to build connections in our communities to start to alleviate these gaps.

The factors that play the greatest role in Minnesota’s heath inequities – race, income and ZIP code – reflect the policies, systems and environments in place that prevent people from taking care of themselves. Looking at these influences and creating solutions is critical to creating healthy, strong and thriving communities for generations to come.

In our first episode we examine how health is shared from generation to generation. The episode combines conversations, reflections, and art to explore themes around how we learn about and come to understand health.