Bilingual patient advocates like Patricia Santos, at right, promote health equity by helping families with limited English proficiency navigate the complexities of their child's medical journey. Credit: Children's Minnesota

What does it mean to be the only health system in Minnesota devoted to children?

“It means that families count on us to be the kid experts. And that responsibility extends far beyond our hospital walls.”

That’s the point of view of Adriene Thornton, manager of health equity at Children’s Minnesota, the state’s only exclusively pediatric health system.

Thousands of families every year come to Children’s Minnesota for highly specialized medicine, from care for childhood cancer to trauma to rare diseases. And the team delivers that: Children’s Minnesota has more specialists in more disciplines than any other care system in the region.

But childhood health is not just about medical expertise, according to the health system’s leaders.

“We really believe we have a duty to lead,” says Thornton, “to advocate for the wellbeing of all Minnesota kids so that every single child in our community has the opportunity to reach their best health.”

For Adriene and other leaders at the nonprofit health system, that means championing policies that support healthy, happy childhoods and addressing the social determinants of health, such as poverty, lack of education, food insecurity, racism and language barriers.

Recognizing that a majority of a person’s health is determined by such social factors, Children’s Minnesota launched its Collective for Community Health in 2022. Its aim: improve the health of children and families — both inside and outside hospital walls — by collaborating with community partners and other organizations.

The Collective anchors Children’s Minnesota’s partnerships in many ways, including not just formal advocacy but connecting families with social and legal services to address health-related needs (like food, housing, legal support).

The Collective is already making a difference: During the 2023 Minnesota legislative session, its advocacy team partnered with community organizations and associations to get policies passed that benefit kids and families — like a new law that gives Minnesota students free lunch at school. The team also successfully advocated for passage of the CROWN Act, which protects against discrimination based on a person’s hair style or texture. 

Expertise in childhood health equity requires data and intentionality. That’s why the Children’s Minnesota leadership team developed a pediatric health equity dashboard to identify and respond to disparities in processes and patient outcomes. Begun in 2018, the tool measures gaps that have serious impacts on patient families, enabling clinical leaders to formally address the implicit, institutional and structural biases that affect quality of care.

Data from the dashboard revealed, for example, that Black children who live in underserved neighborhoods in the Twin Cities experience significant health disparities and are less likely to achieve well-controlled asthma and complete routine childhood vaccines. They also have significantly lower rates of adolescent mental health screenings. In response, Children’s Minnesota is partnering with United Health Group to provide culturally responsive health interventions with existing community partners and local public school districts, specifically targeting asthma management, vaccinations and mental health.

A serious barrier to equitable care, specifically for Minnesota’s immigrant population, is language. Children’s Minnesota offers interpreter services for 70+ languages, free of charge, 24 hours a day, 7 days a week. They also have bilingual patient advocates who partner with families on a longer care journey to navigate a complicated and foreign health system.

For advocates like Patricia Santos, who supports Spanish-speaking families seeking care from the Cancer and Blood Disorders program at Children’s Minnesota, the role goes beyond just translating. She’s an advocate for the entire family. In some cases, she’s working with undocumented parents who are navigating not just their child’s illness but major cultural, social and linguistic barriers. She considers it an honor to walk alongside families in their journey, however complex.

For Thornton, who began her career as a nurse and infection prevention specialist, the upcoming flu season is one more opportunity to make a difference in health equity. She’s leading the mobile vaccine clinics that travel around the Twin Cities to reach people who may not typically seek out a clinic appointment for a flu shot.

Equality is offering everyone vaccine appointments at our clinics. Equity is realizing not everyone is going to be able to benefit from those clinics and then going out to the community to provide what they need when they need it, how they need it, where they need it.”


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