DAVID GREENE, HOST:
When George Floyd was killed by police earlier this year, it sparked both massive protests and conversations about the many ways racial inequality plays out in this country. One of those ways is health. Black people are twice as likely to die of heart disease and COVID-19 as white people. Those differences are visible in one of Minneapolis' most diverse neighborhoods. It's just three miles from where George Floyd was killed. But there's a clinic there that has decades of experience grappling with race and health. And it's now being held up as a model. NPR's Yuki Noguchi has been reporting in north Minneapolis and joins me. Hi, Yuki.
YUKI NOGUCHI, BYLINE: Hi, David.
GREENE: So take us there. What got you interested in this neighborhood?
NOGUCHI: Yeah. What interested me in north Minneapolis is its incredible racial diversity within a state that's mostly white. Ninety percent of residents there are a racial minority. It's about half Black, about a third Latino and about a tenth Asian, mostly Southeast Asian. And the area reflects what we know nationally, that communities of color have more health problems, especially now with the pandemic. Cases of COVID in north Minneapolis run five to six times higher than the state.
GREENE: So it's safe to say this is a place that's been grappling with questions about race and health and that relationship for a very long time.
NOGUCHI: Absolutely. North Minneapolis is like a poster child for race and its effect on health. And that's been the case for decades.
GREENE: Well, I know we're going to talk about this one clinic I mentioned, but, you know, you mentioned the case, for decades. I mean, tell us more about that history.
NOGUCHI: You know, George Floyd's death struck a real chord here. And the protests afterward felt like a real echo from the past. And to explain why, let me take you back 53 years ago. There were similar protests there back then. There was unrest over discrimination, including in access to health care, among other things. And that led to similar sort of rioting and protests on the streets of north Minneapolis.
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UNIDENTIFIED REPORTER: Violence on the city's north side, gruesome isolated acts to mob action. Store windows were shattered by hundreds of stones and bricks.
NOGUCHI: A man named Gary Cunningham remembers that. He grew up on Plymouth Avenue in north Minneapolis. And in the summer of '67, he watched it burn.
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UNIDENTIFIED PROTESTERS: (Shouting).
GARY CUNNINGHAM: I was 10 years old at the time. But it was very traumatizing to see all these Black people getting beat up by police and the fires right on our block.
NOGUCHI: You know, back then, Plymouth Avenue had a lot of shops catering to mostly Jewish and Black residents. But getting medical care was a problem.
CUNNINGHAM: There was a issue with the ambulance service. The ambulance wouldn't serve Black community there.
NOGUCHI: So to see a doctor, Cunningham and his mother had to take the bus across town.
CUNNINGHAM: Most Blacks went to Dr. Brown. His office would be, like, 200 people in the waiting room because he was one of the few Black physicians. There was a couple of Black physicians there. Access to care was a major issue for Black people.
NOGUCHI: And the government tried to close that gap. President Lyndon Johnson's War on Poverty set up pilot programs in 14 cities to offer health and social services. And that's when North Minneapolis got something it hadn't had before, a community health center. It opened months after the 67 riots and was known as Pilot City. It was located in an old synagogue on Plymouth Avenue, just three blocks from where Cunningham lived. Today, it's called NorthPoint Health and Wellness.
GREENE: That's NPR's Yuki Noguchi there talking to us about north Minneapolis and the history. And, Yuki, I mean, how important is having access to a community health center like that? It sounds like a really big deal.
NOGUCHI: Yeah, it was because it was nearby, but also because of how the clinic operates. And here's Gary Cunningham again.
CUNNINGHAM: I just remember it being a place where community gathered. The health center at that time and the social service center were one place.
NOGUCHI: And, David, you notice how Cunningham talks about health and social service in the same breath there? That's key to understanding what makes NorthPoint different. It looks at the social reasons that people end up with the health conditions they have. That concept's become very popular recently, but it's been NorthPoint's focus for decades. So here's an example of what I mean. Four decades after Pilot City - now NorthPoint - started, Gary Cunningham ended up taking it over as CEO.
And at the time, the clinic was in disarray. I mean, patients weren't getting regular vaccinations or mammogram screenings. And under Cunningham, it developed some unusual solutions. It provided bus tokens to patients who couldn't otherwise afford transportation. And they made inroads with a growing Somali and Hmong population by hosting lunch events with religious leaders and food from those communities.
GREENE: And did that make a difference? I mean, did you see the vaccination or screening rates start to change?
NOGUCHI: Yeah, it did. I mean, in 15 years, childhood vaccinations and mammogram rates have more than doubled to close to 80%. But it's not just vaccinations, David. I mean, diabetes, lead poisoning and depression are also huge problems there. So NorthPoint lobbied to remove lead paint from homes. It stocks, even today, a free food shelf with healthy, culturally relevant food. People are screened for depression and dental care just automatically. So David, what you're seeing here is that instead of just writing a prescription, NorthPoint is looking at the whole picture. It treats disease not just as a medical problem, but one that has social roots.
GREENE: And is that still the case even in the middle of a pandemic and all the extra challenges we are seeing right now? Is that approach still working?
NOGUCHI: Yeah. And one of the great things about this model is that it's developed a lot of trust in the community. You know, a majority of NorthPoint's board of directors is run by patients from the community. They reflect the community. And NorthPoint's current CEO, Stella Whitney-West, told me that is critical.
STELLA WHITNEY-WEST: The people who operate or who have the responsibility for overseeing your clinic are the same people who are the patients and customers of your clinic.
NOGUCHI: You know, they know what the community needs even right now because they are the community. And so people trust them, which is critically important during the pandemic. Nearly two-thirds of Latino patients testing for COVID at NorthPoint test positive. That's extremely high and very worrisome. But Whitney-West says it's also a positive sign. It means undocumented immigrants trust NorthPoint.
WHITNEY-WEST: When I talked with the staff, they started telling me people feel safe here. So they're likely to come here as opposed to going downtown to the hospital.
NOGUCHI: And from a public health standpoint, that's essential. You know, you need to know where the virus is in order to stop its spread. And, you know, David, we are at a critical time right now, with COVID cases spiking around the country. And a lot of experts are saying we need more of a public health approach to delivering care, the very kind of thing NorthPoint has been championing for decades.
GREENE: Well - and, Yuki, I know this is just the beginning of your reporting. And we're going to be hearing your reporting on other aspects of race and public health. NPR's Yuki Noguchi, thank you so much.
NOGUCHI: Thank you, David.
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