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Today, we want to invite you to take a virtual visit with us to Minnesota, where we’re building new collaborations that inform health equity work across the state!

In the latest issue of Health Affairs, we published COVID-19 vaccination rates among Minnesotans experiencing homelessness or incarceration (in jail or prison).

The takeaway: rates of vaccination for people experiencing homelessness or incarceration in jail remain too low, especially for COVID-19 boosters.

To help close outreach and resources gaps, we’ve developed tools in Minnesota to help inform and evaluate interventions to progress toward our goals to eliminate health inequities.

The vaccination rates highlighted in our study were generated using data from the Minnesota Electronic Health Record Consortium (MNEHRC), a collaboration that emerged during the pandemic between eleven health systems in Minnesota and the Minnesota Department of Health to inform policy and practice through data.

The MNEHRC developed a distributed data model with linkages to statewide data and the ability to deduplicate records. Each site analyzes its data locally and generates summary reports that are then aggregated centrally.

This approach allows the group to assess trends and disparities in COVID-19 prevalence, testing, and vaccination, including among key subgroups at high risk of COVID-19 and severe disease, without a central data repository.

We founded the Health, Homelessness & Criminal Justice Lab within the Hennepin Healthcare Research Institute to overcome barriers to optimal health and wellness for people experiencing homelessness and/or criminal justice involvement through research and collaboration.

At the Lab we believe that producing timely and policy-relevant data about these two key populations can serve an important role in promoting action to achieve equity in health and health care delivery for people who have experienced homelessness or criminal justice involvement.

It has been exciting for our lab to work with collaborators in the MNEHRC to harness its data resources across the state and produce vaccination data for people experiencing homelessness and incarceration.

Historically, siloed data across sectors have created substantial barriers to evaluation of health-related interventions for people experiencing homelessness or incarceration.

Further, when data linkage is feasible, it is typically with an individual city or county or with payer data that excludes uninsured populations.

The ability of the MNEHRC to link homelessness and incarceration data with data from EHRs across the entire state has allowed us to produce estimates of COVID-19 vaccination in near real-time that would have been otherwise impossible to produce.

We believe the MNEHRC’s creative approach to data linkage and collaboration are the future of public health.

Such data are granular enough inform the policy and practice decisions needed to address longstanding health disparities among people experiencing homelessness and/or incarceration, as well as other historically marginalized populations.

This approach can also extend beyond COVID into other chronic physical health, mental health, and substance use conditions.

In past work, we were able to link criminal justice, housing, and Medicaid claims to show that people with high levels of health care use also had high levels of other types of service use.

We believe the MNEHRC is an improvement on that model because it provides a lens into health patterns for an entire statewide population and is not limited by payer.The MNEHRC produces timely, near real-time data (only delayed one week).

We are just beginning to comprehend the opportunities this level of data integration offers and are grateful for all our partners across Minnesota who chose to participate in this project.

If you do journey to our great state of Minnesota in real life (we recommend a visit from June 20 to August 20 when the almanac assures us it’s “probably” never snowed), we’d encourage you to visit our great state parks, city lakes, and let us know when you want to stop by for a tour of the Health, Homelessness & Criminal Justice Lab.

Today in Health Affairs Forefront, Chelsea Clinton and Katelyn Yoo argue that COVAX is not sufficient to vaccinate the world and its failures are the failures of a global health paradigm which relies on charity rather than solidarity, elevating the concept of response over building resilience.

Eleanor Perfetto and coauthors ask, “What should be measured and monitored?” when it comes to enhancing value by evaluating health care services.

Elevating Voices: Pride Month: In a September 2021 article, Landon Hughes and coauthors documented that privately-insured transgender people are at a greater risk for morbidity, including greater risk of several chronic cardiovascular and neurological conditions, than their cisgender counterparts.

Hughes also discusses the research on an episode of A Health Podyssey.

About Health Affairs

Health Affairs is the leading peer-reviewed journal at the intersection of health, health care, and policy. Published monthly by Project HOPE, the journal is available in print and online. Late-breaking content is also found through healthaffairs.org, Health Affairs Today, and Health Affairs Sunday Update.

Project HOPE is a global health and humanitarian relief organization that places power in the hands of local health care workers to save lives across the globe. Project HOPE has published Health Affairs since 1981.

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