Message from director
Over the past year, COVID-19 has continued to impact our work. Our efforts have moved from direct response activities – like testing and vaccination – to addressing secondary effects of the pandemic, such as poor mental health, the worsening opioid epidemic, and a troubling decline in routine childhood immunizations.
We’re taking lessons we’ve learned from the pandemic and using them to inform and improve our work in Hennepin County.
For example, we’ve learned that routine, but essential, public health work – like WIC services, restaurant inspections, and tuberculosis treatment – doesn’t stop during a pandemic, but you have to do things differently. COVID-19 and the embracing of telehealth services provided opportunities to innovate and improve how we deliver services for county residents.
We also learned that effective outbreak response requires strong and modern public health infrastructure. During the pandemic the community demanded accessible, real-time data. Our COVID-19 data improved and evolved in response. The new tools and practices we brought in are helping to modernize our epidemiology work.
Our department has been working to advance health and racial equity for years. COVID-19, and the murder of George Floyd, also showed us how far we still have to go. These painful events led us to rededicate ourselves to centering racial equity in our work. It also set us on a path toward becoming a trauma informed health department.
In this report, we share a few stories to illustrate ways we are taking our learnings and partnering with community to reduce disparities and improve health. I hope you’ll notice that our department is engaged in diverse, wide-ranging work that touches nearly every part of community life. These highlights are not comprehensive of our work, but I hope they give you a sense of why I’m so proud and grateful to lead this department. Thanks for making time to read Hennepin County Public Health’s 2022 highlights.
Susan Palchick, PhD, MPH
Hennepin County Public Health director
Contents
The links, below, represent sections of the report. Scroll down to continue reading the report, or click on any of the links to go directly to that section.
Community mental health and well-being
Thank you for supporting our efforts to protect and improve the health of all people in Hennepin County.
In February 2022, Deshaun Hill, a 15-year-old North High School student, died from gunfire. As the tragedy reverberated through his school, staff from Cope, our 24/7 mobile crisis response program, organized a healing circle for members of Deshaun’s football team. Community interventions like this are a new way of working for Cope and allow the program to intervene earlier.
Standing in the school’s weight room, Cope staff explained the rules of a healing circle: People pass a “talking stick” around the circle. Only the person holding the stick can talk and others are expected to listen.
When they began the healing circle, people were hesitant to speak. But after a Cope staff member shared about tragedy in his own life, the football coach and team opened up. For the next 90 minutes, they shared stories about Deshuan and began healing.
In addition to Cope, many of our programs are engaged in mental health and well-being initiatives. For example, health mentors in our Better Together Hennepin program provide youth with self-care and stress reduction tools and referrals to mental health practitioners. And our Health Promotion program collaborates with Allina Health on Change to Chill, a website with culturally specific mental health resources.
COVID-19 worsened mental health and mental well-being for youth and adults. For example, students who took the 2022 Minnesota Student Survey reported greater struggles with mental health, such as depression and anxiety, than at any other time in the history of the survey, which began in 1989 and occurs every three years. According to the 2022 survey, 29% of students reporting long-term mental health problems, compared to 23% in 2019 and 18% in 2016. Long-term means problems lasting six months or more.
Opioid overdose deaths in Minnesota and Hennepin County continue to rise, matching nationwide trends. In 2021, 340 Hennepin County residents died from an opioid overdose. Fentanyl, a powerful synthetic opioid, is a leading cause of the recent increases in opioid overdose deaths.
Public Health helps lead implementation of the county's opioid prevention strategic framework and coordinates the work of several county departments to implement and expand opioid interventions.
Increasing the county’s capacity to monitor and share opioid use data is a notable and ongoing intervention. Hennepin County opioid response staff have partnered with the Hennepin Healthcare Research Institute to track substance use related visits at hospital systems across the county. Another recent project combines data from the county’s Human Services, Public Health, and Public Safety departments to analyze how people who use opioids interact with county services. Both efforts help the county identify opportunities to connect people with support and resources.
To increase access to interventions at the community level, Hennepin County launched 17 multi-year contracts with community organizations who provide culturally relevant services to American Indian, African American, unsheltered homeless, and Somali/East African communities. The organizations offer a variety of evidence-based services, including:
Providing opioid prevention services to the East African community (healthyhennepin.org)
Tackling two epidemics (healthyhennepin.org)
The opioid epidemic affects people from all walks of life, but the burden falls disproportionately on American Indian, African American, Somali/East African, and on people experiencing unsheltered homelessness. These differences are influenced by the conditions that affect health, such as housing, food, healthcare, and economic well-being. Our approach is informed by data and community engagement. It helps address the increasing need for opioid prevention, response, and treatment resources at the county and community level.
Mpox, previously referred to as monkeypox, is a disease caused by the monkeypox virus that is mostly spread from close, skin-to-skin contact. Between June 2022 and December 2022, there were 234 confirmed Mpox cases in Minnesota, most occurring in Hennepin County. Most cases in Minnesota have occurred among men who have sex with men (MSM).
Our Red Door Clinic emerged as a leader in Minnesota’s Mpox response, diagnosing the first case in the state and providing the majority of Mpox vaccine doses. Red Door has been a trusted resource for LGBTQ+ sexual health care for over 50 years, making it uniquely positioned to reach the MSM community and others at risk of contracting Mpox.
Red Door effectively used social media and hook up apps to offer Mpox education and resources directly to the affected community.
In 2022, Red Door gave an impressive amount of Mpox vaccine – over 7,000 doses, which accounts for over 50% of Minnesota’s vaccine distribution. Red Door also worked with the department’s Community Based Infectious Disease (CBID) team to administer 176 doses at eight vaccine events at an LGBTQ+ bar in Minneapolis. Many of the people who received vaccine at these community events were Black and Latinx: two groups disproportionately impacted by the outbreak.
The fight against Mpox continues, but thanks to the impact of Red Door and other partners, cases of Mpox have fallen dramatically. Red Door continues to administer Mpox vaccine and is planning more community vaccine events for 2023.
The Mpox outbreak disproportionality impacted groups experiencing health disparities, including Black and Latinx MSM. Red Door’s response, including our collaboration with the Saloon and CLUES, exemplifies our department’s commitment to making services accessible for communities. By providing culturally relevant care and communications, we reduced stigma and helped community members get the care and support they needed to stay healthy.
Red Door Clinic was featured in a number of news articles including in MPR, MINNPOST, and Kare11.
To learn more about Mpox and vaccine eligibility, please visit Red Door's website.
Every four years, our department administers the SHAPE survey to help understand the health needs of our diverse community. SHAPE stands for “Adult Survey of the Health of All the Population and the Environment.” This is the seventh time in 24 years we’ve conducted our assessment of community health.
The 2022 SHAPE survey asked residents questions about their health, diet, exercise, neighborhood, and this time, about the impacts of COVID-19. The goal of these new questions is to understand the effects of COVID-19 on residents’ mental well-being, children’s access to education, and more.
In addition to mailing the survey to 40,000 randomly selected households, the SHAPE team partnered with eight community organizations and federally qualified health centers to host 50 in-person data collection events. The SHAPE team worked with community partners to offer Somali, Spanish, and Hmong language support at the events. These efforts aim to increase the representativeness of the survey.
Tyrone from North Minneapolis took the 2022 SHAPE survey at an event at NorthPoint Health and Wellness Center. “The SHAPE team was talking about community,” Tyrone said. “And I want a voice in community. I live in it!”
In total, residents completed 8,093 mail surveys and 2,133 in-person surveys. SHAPE 2022 survey results will be shared in 2023.
SHAPE results help us understand how healthy residents are, examine differences in health among different communities, and understand how social factors such as income, education, and housing stability affect health. Community organizations also can use this data to drive their work.
Climate change is causing challenging situations – like extreme heat, severe weather, and wildfires -- that impact health and exacerbate existing health disparities. The county aims to protect residents from these health impacts through its climate action plan.
In 2021, our department finalized a Public Health Climate Action Plan that aligns with the county’s plan.
Improving food security is one of the key parts of the Public Health Climate Action Plan. Our department is currently involved in several food security projects.
These food security projects are important for several reasons. Climate change influences weather patterns that reduce food availability and increase food costs. At the same time, one third of surplus food that isn't eaten ends up in landfills where it creates greenhouse gases that contribute to climate change. A stronger food security system can direct more food to those in the community who need it the most while reducing food waste.
Our Health Promotion program coordinates and manages food security contracts with local food shelves and hot meal programs. These contracts provide funding to food security organizations to fill operational gaps and increase their capacity to serve people in need of healthy, culturally specific food. Health Promotion is a partner of the Hennepin County health disparity food security workgroup that champions this effort.
Strengthening sustainable access to food can help increase the resilience of those experiencing hunger and reduce the amount of food wasted. Climate change impacts, like hunger, disproportionately impact people who already experience health limiting factors like low income, low-quality housing, and lack of transportation. By building a more climate resilient community, especially in areas that have the greatest vulnerabilities, we can help disrupt disparities and protect public health.
Create meals, not waste: Planning ahead to reduce food waste (hennepin.us)
Eat the food you buy: Storing food to make it last (hennepin.us)
Since 2020, Hennepin County employees have worked tirelessly to respond to the COVID-19 pandemic. From conducting case investigations and contact tracing, to running testing and vaccination events, and more – these efforts have centered disproportionately impacted communities and helped keep people safe and healthy.
One of our pandemic response efforts was offering vaccine stipends to community partners to promote COVID-19 vaccination. This began in early 2021, when Hennepin County started receiving requests from community-based organizations to partner on vaccine events. Public Health staff subsequently built a process for supporting community vaccine clinics.
The county offered planning help, $3000-$5000 stipends; and sometimes helped staff the events. In 2022, the county awarded 188 vaccine stipends and partnered with 71 community organizations to administer over 8,300 doses of COVID-19 vaccine.
Each vaccine event was unique to the community it served. Special features ranged from food trucks, and dance lessons, to cultural performances and raffles. The stipend program wrapped its efforts in November 2022.
The organizations that Hennepin County partnered with throughout the COVID-19 response understood that a culturally welcoming space could ease concerns and lead to better vaccine uptake in their communities. “The vaccine is safe. It is effective. It is our responsibility. It’s not just about protecting yourself; it’s about protecting others. Your choice can affect our communities,” said Korawan, who partnered with Hennepin County to plan a vaccine event for members of the Thai and East Asian communities.
While COVID-19 efforts have been winding down since mid-2022, the Hennepin County Public Health Clinic continues to offer vaccinations and boosters for all ages. Hennepin County is also moving into a variety of recovery efforts related to COVID-19.
One recovery effort is addressing the declining rates of routine childhood immunizations. Per the Minnesota Department of Health, 33.6% of children are not up to date on their vaccinations. This is up compared to 19.7% in 2019.
Our department has several programs that help parents get their children immunized. Additionally, we launched a childhood immunization marketing campaign in 2022 to help bring up the rates. The campaign resulted in over 7,000 hits to our immunization website. Campaign metrics indicate that 49% of Hennepin County parents of children ages 0-17 saw the ads during the month-long campaign.
Due to the COVID-19 pandemic, childhood immunization rates have fallen in Minnesota and nationally. Childhood immunizations protect kids and families from serious diseases like COVID-19, measles, mumps, and diphtheria.
Supporting vaccine events: A heart for community (healthyhennepin.org)
Bringing vaccination to community (healthyhennepin.org)
