Minnesota’s Ongoing Needs Assessment Activities

The Needs Assessment update for this year focused on continued collection, analysis, and reporting on the priority areas highlighted in our 2020 Needs Assessment. Data from vital statistics, national surveys, and surveys specific to Minnesota were analyzed and prepared for dissemination. Many of the same trends and persistent disparities were present in the data. Our Title V Needs Assessment team focused on finding information on the impacts of COVID-19 and data on systemic racism to frame our health inequities for each priority areas. We also reviewed community input from Minnesota’s COVID-19 response.

Once again, we heard loud and clear the need to focus our efforts on health equity and the social determinants of health.

Priority Briefs

Community facing Priority Briefs (hyperlinked below) were created for each of Minnesota’s Title V 2021-2025 priority areas identified during Minnesota’s 2020 Needs Assessment. The priority briefs give an overview of the status of each priority area in Minnesota, highlighting health inequities and the impacts of COVID-19. Each brief includes an outline of the strategies for addressing each priority area, along with some of the activities that the Division of Child and Family Health (CFH) and their partners plan to do to support the work of those strategies. These strategies align with work done by the multidisciplinary Strategy Teams throughout the CFH Strategic Planning process (for more information see our CFH Strategic Planning website).

Title V 2021-2025 priority area include:

• Access to Services and Supports for Children and Youth with Special Health Needs and their Families
• Accessible and Affordable Health Care
• Adolescent Suicide
• American Indian Family Health
• Care during Pregnancy and Delivery
• Comprehensive Early Childhood Systems
• Housing
• Infant Mortality
• Mental Well-Being
• Parent and Caregiver Support

Collecting Success Stories for Minnesota’s Priority Areas

With two-thirds of our Title V dollars granted to local public health, the Title V Needs Assessment team is working to build a holistic view of maternal and child health work in the state. To highlight successes of our partners in this work, other public health programs/organizations across Minnesota, we are collecting data about the diverse and amazing work of programs/organizations from all levels of public health across Minnesota through our newly created Title V Maternal and Child Health Success Survey.

Along with disseminating the survey over the next couple of years, our Title V Needs Assessment team plan on doing outreach to collect more success stories. Individuals/organizations can choose to fill out the survey, sign up for an informational interview with a member of the Title V team, or upload a report. Success stories pertaining to the Title V MCH Block Grant priority areas may be featured in our priority briefs, be highlighted on our social media accounts, or included in legislative/federal reporting.

Operationalizing Minnesota’s Needs Assessment Process and Findings

The CFH Division at MDH acknowledges that to advance MCH outcomes and equity, we need to work together in authentic, collaborative, and innovative ways. This is the only way that we will be able to reduce the disparities in our communities. Therefore, we have taken a different approach toward our 2020 needs assessment, prioritization, and strategy development/strategic planning process. The foundation of this new approach rests in the belief that solutions lie within the community and as such, the focus is on engaging with the community to ensure that we are planning and implementing programs and initiatives that will have the greatest impact and benefit.

Following the completion of our statewide 2020 Needs Assessment, Minnesota entered a strategic planning process. The intent of the strategic planning process was to develop, in partnership with stakeholders, a set of strategies to address each priority need identified during the 2020 Needs Assessment. These strategies are being used to guide the work of the CFH Division for the next five years and are incorporated into the state’s Title V MCH Block Grant action plan. The strategic planning process included the creation of multidisciplinary Strategy Teams. During discussions each strategy team had, they discussed definitions of important terms, guiding principles to choose the strategies they should focus on to support their priority area, and ultimately chose strategies and action items that could be taken. Many of the discussions were around how we can specifically address the disparities of the American Indian tribal nations, BIPOC, and LGBTQ+ communities, and resiliency building for those suffering from trauma. Many of the strategies emphasize equity, including investing in community solutions to community-identified challenges, increasing information sharing across state agencies to create a more accessible system for parents and caregivers, and providing early childhood workforce supports.

CFH planned to continue to engage with the community via strategy teams for each of the priority needs. The plan included an annual meeting to discuss progress on the strategies and discuss whether changes need to be made for subsequent years. Due to the COVID-19 pandemic, we were unable to engage with the strategy teams as planned during FY2021 to discuss plans for FY2022. However, we continued to solicit feedback from our Strategy Teams including review of the Priority Briefs and Action Plan. Plans are being developed to engage with the strategy teams during FY2022.

Many of the priority needs identified through our 2020 Title V Needs Assessment (e.g., Housing, American Indian Family Health, and Parent/Caregiver Support, etc.) are new areas of focus for our Title V program. CFH needs to collaborate with partners to improve MCH and CYSHN outcomes in these areas because we don’t have prior experience working directly on these issues. Addressing these issues will require a clear understanding of how our current systems work, what partnerships exist, and what partnerships need to be established to leverage collective impact and improve the health and well-being of Minnesota’s MCH and CYSHN populations. In the summer of 2021 two MCH Workforce Development Center Title V interns assisted Minnesota’s Title V team with the work of operationalizing our Title V Action Plan and our ongoing Needs Assessment work. They created a system map for two of our new cross-cutting priority areas: Housing and Parent/Caregiver Support. We plan to continue this work by creating system maps for all our cross-cutting/new priority areas.

Changes in Needs/Health Status of MN MCH Populations

COVID-19 Pandemic

As the pandemic continues, issues continue to emerge that will impact the work of our CFH Division moving forward. The pandemic has exacerbated the disparities that exist within the state. Health outcomes for those with COVID-19 have been poorest for those communities most impacted by housing instability, food insecurity, and health care access.

 Specifically, in MCH populations we have found:

• At the beginning of the pandemic, well-child and well-women visit and immunization rates declined as families delayed routine health care and/or providers limited the availability of some services to ensure capacity to respond to COVID infections in the population. Some health care systems reduced the number of in-person prenatal visits and limited the number of people who could be present during the birth and hospital stay.[1]
• As a result of COVID-19, children and adolescents have experienced unprecedented interruptions to their daily lives and some recent findings indicate that COVID-19 restrictions have impacted youth mental health due to lack of peer contact, social support, and activities, familial stress, and economic hardship within the family. A Kaiser Family Foundation analysis of data from the Census Bureau’s Household Pulse Survey shows that during the pandemic, more than half of young adults (ages 18-24) reported symptoms of anxiety and/or depressive disorder (56%).[2]
• CYSHN may be at increased risk for complications from COVID-19. In addition, school and other closings affect the availability of important therapies and supports for CYSHN.[3]
• Pregnant people and recently pregnant people are at an increased risk for severe illness when they contract COVID-19 compared to non-pregnant people. Pregnant people who contract COVID-19 are also at an increased risk of delivering before 37 weeks (preterm) and may have an increased risk for other poor pregnancy outcomes.[4]
• Minnesota has seen an increase in unsheltered homelessness since the beginning of the pandemic, culminating in the largest encampment in the state’s history at Powderhorn Park in Minneapolis, where the best estimate showed 282 people living together outdoors. The increase in unsheltered homelessness is attributed in part to people not feeling safe in congregated shelters, as well as displacement of those who were doubled up or precariously housed before the pandemic.[5] 
• Between May 2020 and August 2020, Black and Latina/o households experienced a 7% increase in rates of evictions and foreclosures, while White households increased 2%.[6] To address eviction and foreclosure inequities, Minnesota announced on July 14th, 2020, that it would be dedicating $100 million in housing assistance to homeowners and renters in the state. Funding for the COVID Housing Assistance Program (CHAP) comes from the federal CARES Act.[7]
• Minnesota’s uninsured rate weathered the economic shock of the pandemic in the first half of 2020, staying at a historically low rate of about 5% through July 2020. Much of the loss of employer provided insurance in Minnesota was offset by increased enrollment in public and individual coverage.[8]

• African American and Black Minnesotans and Latina/o Minnesotans make up 7% and 6% of the overall state population, respectively. As of June 2022, African American and Black Minnesotans also constituted 8% of confirmed COVID-19 cases and 11% of COVID-19 hospitalizations while Latinx Minnesotans constituted 7% of confirmed COVID-19 cases and 6% of hospitalizations.[9] Additionally, Black and Latinx children had higher rates of COVID-19 hospitalizations as compared to White children, reflecting the disparities rooted in systemic racism seen in adult populations.[10]
• Tribal communities in Minnesota have been lauded for their rapid vaccine rollout. During the Leech Lake Band of Ojibwe’s annual State of the Band Address in March 2021, Lieutenant Governor Peggy Flanagan remarked, “I can tell you, no one has seemed to vaccinate more folks than Leech Lake. It's really been a tremendous thing to watch.” The Leech Lake tribal nation has provided vaccines to both Native and non-Native community members to create a circle of protection from COVID-19 in their community.[11]

Anti-Racism and Racial Justice Movement

Since the murder of George Floyd at the hands of Minneapolis police, and the resulting civil unrest, there has been amplified attention to inherent racism in our systems and policies. Even with the unprecedented guilty verdict of George Floyd’s murder, Minneapolis and the Twin Cities continue to be on edge with two more deaths of Black men, Daunte Wright and Winston Smith Jr., at the hands of police.

The historical and on-going trauma for Black, Indigenous, and people of color (BIPOC), the disproportionate impact of the COVID-19 pandemic, and the murder of Black men and women at the hands of police necessitates an understanding of the impact and an organizational response to the trauma inflicted on these communities. Additionally, it is imperative to develop ways to support community healing and well-being, as well as recognize the resilience inherent in these communities.

As part of our ongoing needs assessment process, we are digging into and working to call out data on systemic racism and structural inequities to frame Minnesota’s persistent health disparities. Specifically, in our current Title V 2021-2025 priority area’s we have found:

• New research indicates that racial discrimination is also linked to suicidal thoughts.[12] However, a separate study led by the same researchers found the effects of racism could be mitigated with one’s ability to emotionally and psychologically reframe an incident through cognitive flexibility and forgiveness.[13] It is important to note that internal coping strategies like dispositional forgiveness (the ability to reframe an incident) are not the same as excusing, encouraging reconciliation, or freeing an offender from the consequences of their actions. To truly eliminate these inequities in the long run, these internal coping strategies must be combined with broader structural changes.
• While national data on inequities among CYSHN can help identify the gaps in access to services and supports that exist for certain subgroups of CYSHN, it is difficult to report on important differences in access to services and supports at the state level due to data limitations. Minnesota is unable to conduct sub-analyses at the state level, even when combining data years, due to small sample sizes. Though data limitations exist, we do know that there are strong connections between racism and ableism that lead to barriers to care and ultimately poorer outcomes. It is important to understand how racism and ableism are linked and how that impacts Black, Indigenous, and People of Color (BIPOC) with disabilities/special health needs.[14]
• Systemic racism is pervasive within health care and the economic system and has led to inequities in access to and affordability of health care by race/ethnicity.[15] According to the Minnesota Health Access Survey, 10.2% of BIPOC Minnesotans were uninsured compared to 2.4% of White Minnesotans in 2021. Additionally, structural racism affected whether children of color have access to and receive family-centered care – while 92.6% of White children received family-centered care between 2019 and 2020, only 81.3% of Hispanic children and 73.1% of Black children did.[16]
• American Indian women, children, and families experience the greatest health disparities in Minnesota. For instance, 2020 5-year American Community Survey estimates showed that approximately 37.6% of American Indian children under 18 years old lived below the poverty level in Minnesota compared to 11.6% of all children in the state. [17] Only 52.5% of American Indian youth in Minnesota graduated from high school on time compared to 83.3% of all youth in the state.[18] Compared to White children, American Indian children in Minnesota are 16.4 times more likely to be placed in out-of-home care.[19] These disparities are caused by historical trauma, racism, and continued colonial practices and policies that create barriers to opportunity and thriving. Oppressive systems have denied American Indians access to adequate health care, employment, and food and nutrition.
• As a result of systemic racism, preliminary data from Minnesota Vital Records, 2011-2019, shows African American/Black pregnant people and American Indian pregnant people die during pregnancy, delivery, or the year post-delivery at rates 1.8 times and 8.1 times higher respectively than non-Hispanic White people. American Indian pregnant people, for example, systematically experience the lowest rates of prenatal care and the highest rates of giving birth prematurely to a baby with low birthweight in Minnesota.[20]
• In Minnesota, children are not guaranteed access to early childhood education, which means that this education is most often financed by parent’s tuition payments to private programs. The median family income in Minnesota for American Indian, Black, and Hispanic families with children is $34,000 to $52,900, compared to $108,600 for White families with children.[21] Additionally, data from the Early Childhood Longitudinal Database (ECLDS) shows that, in 2019, 84.7% of African American/Black and 79.4% of American Indian/Alaska Native kindergarteners received economic assistance and/or food assistance, while only 23.3% of White kindergartners received assistance.
• Indigenous peoples in Minnesota continue to be affected by land theft and land treaties that were broken by the U.S. government.[22] The Minnesota Department of Health, for example, occupies land stolen from the Dakhóta people. Additionally, multiple generations of Minneapolis residents were (and are) affected by discriminatory federal housing policies, zoning regulations, and lending practices that aimed to keep certain people in certain areas in specific types of housing.[23] Redlining from early in the 20th century has left a lasting effect on the neighborhoods of Minneapolis, with the zoning map for much of the city remaining largely unchanged from the era of intentional racial segregation. Since the year 2000, White and Asian households in Minneapolis have seen an increase in household income, while African American/Black households have experienced an approximately 40% decrease in income during the same time period.9 Rising housing costs in the face of decreased income means that many individuals in the Twin Cities, particularly people of color and undocumented immigrant communities, do not have access to affordable, quality housing.
• While infant mortality rates for all racial groups in Minnesota have declined over time, the disparities have remained constant for over 20 years. According to the Minnesota Linked Birth/Death File, the infant mortality rate among infants born to African American/Black birthing people and American Indian birthing people is over two times greater than among non-Hispanic White birthing persons in Minnesota. The infant mortality rates among African Americans/Black people in Minnesota vary greatly depending on the birthing parent’s country of birth. From 2016-2020, U.S. born African American/Black birthing people had an infant mortality rate of 10.1 per 1,000 compared to foreign-born birthing people who had an infant mortality rate of 6.2 per 1,000.
• As a result of structural racism, Black birthing people are more likely to live in over-policed neighborhoods in Minneapolis compared to White birthing people. [24] While the stress associated with greater police presence negatively impacts birth outcomes among all birthing people, U.S. born Black birthing people living in an over-policed neighborhood have the highest odds of preterm births (2.0) compared to foreign-born Black (1.1) and White birthing people (1.9). The difference in preterm birth rates among U.S. born and foreign-born Black birthing people is indicative of the long-term exposure of structural racism on birth outcomes. Although there is limited data on this public health issue, an ongoing 5-year study is further exploring the relationship between racialized police violence, preterm births, and low birthweights among Black infants born in Minnesota and other areas across the country with high incidences of police violence.[25]
• In the 2019 Minnesota Student Survey, while almost half of non-Hispanic White students reported having eight to ten of the mental well-being components, less than 30% of American Indian students reported the same. Overall, non-Hispanic White students reported experiencing higher rates of all well-being components, except for educational engagement, which is higher among Hmong and Asian/Pacific Islanders. Disparities are also seen by race/ethnicity when looking at average number of mentally unhealthy days. Data from the 2021 Minnesota Health Access Survey shows African American/Black individuals had 1.2 more mentally unhealthy days and American Indians had 2.8 more mentally unhealthy days on average in the last 30 days when compared to those who identify as White.
• As a result of structural racism, racial disparities are evident in the amount and source of support parents/caregivers report receiving. For instance, the 2019-2020 National Survey of Children’s Health (NSCH) found that 82.5% of all children have parents who, during the past 12 months, had someone they could turn to for day-to-day emotional support with parenting or raising children. Emotional help received is significantly higher for children who are non-Hispanic White (89.8%) compared with non-Hispanic Asian (57.1%), Hispanic (70.5%), and non-Hispanic Black children (53.5%).

As a public health institution, MDH acknowledges that the failure of our system to meet the needs of our Black, Brown, and Indigenous communities has endured far too long, and we have an urgent obligation to take concrete steps toward equity. To achieve positive change and an end to racism, we must collaborate with the Black, Brown, and Indigenous communities boldly, swiftly, and thoughtfully. We must work to disrupt and dismantle racism in all its manifestations and structures in our policies, systems, programs, and practices that are designed to improve but instead maintain health inequities and injustices in our Black, Indigenous, and communities of color. MDH aims to support future initiatives for collaboration and conversation on issues regarding race and justice and to proactively engage more in advocacy work in the communities most impacted by inequities.

Changes in MN’s Title V Program Capacity or MCH Systems of Care

Beginning in early 2020, MDH responded through its Emergency Preparedness Incident Command Structure to the growing number of COVID-19 cases within the state. Beginning in March 2020, and with no foreseeable end, staff from across the department were reassigned to assist with the response in a variety of roles. Much of the work of the CFH division was put on hold, as over 75% of the staff were assigned to support the response outside the Division. The impact of the pandemic is continuing to be felt in our workforce and will have a lasting impact on the well-being of our workforce and community.

Changes in organizational structure or leadership

The CFH Division has seen a change in our leadership during this block grant period. Joan Brandt, our former CFH Division Director, retired from MDH after over 40 years as a public health nurse, leader, and educator. Noya Woodrich was hired as the new CFH Division Director and started this role in May 2022. Noya has been an advocate for MCH issues for over 30 years.  She received her bachelor’s and master’s degree in Social Work from Augsburg University. While working on her bachelor’s degree she did an internship with the Division of Indian Work in south Minneapolis where she worked for the next 25 years, eventually becoming the organization’s Executive Director. More recently she worked as the Health Director for the Mille Lacs Band of Ojibwe and then Minneapolis Health Department, as the Deputy Commissioner of Health. Her areas of interest and passion in the MCH field include the prevention of infant mortality, the reduction of health and social disparities, especially as they impact communities of color, specifically the American Indian community.

In addition, Elizabeth Taylor-Schiro was hired as the Title V Coordinator in June 2022. Elizabeth received her bachelor’s degree from the University of Wisconsin in Human Development and Family Studies, her master’s degree from the University of Minnesota in Organizational Leadership, Policy, and Development in the Educational Policy and Leadership emphasis, and is currently a PhD Candidate in the University of Minnesota’s Organizational Leadership, Policy, and Development program with an emphasis on Evaluation Studies. She is a passionate advocate for MCH equity, education, and policy, with a professional background in early childhood education, maternal perinatal and postnatal health and wellbeing, and family home visiting. Her areas of interest in the MCH field include community engagement, cross sector approaches to policies and programs, and root cause analysis of disparities within MCH, particularly as they impact communities of color and American Indian communities.

[1] COVID-19 and pregnancy. (2021). The Mother Baby Center. Retrieved from https://www.themotherbabycenter.org/your-pregnancy/covid-19-and-pregnancy-information/

[2] Panchal, N., Kamal R., Cox, C., & R. (2021). The Implications of COVID-19 for Mental Health and Substance Use. Kaiser Family Foundation. Retrieved from https://www.kff.org/coronavirus-covid-19/issue-brief/the-implications-of-covid-19-for-mental-health-and-substance-use/.

[3] COVID-19: Caring for Children and Adolescents with Special Health Care Needs. (July 2021). HealthyChildren.Org. Retrieved from https://www.healthychildren.org/English/health-issues/conditions/COVID-19/Pages/COVID-19-Youth-with-Special-Health-Care-Needs.aspx

[4] Centers for Disease Control and Prevention. (2020). Pregnancy, Breastfeeding, and Caring for Newborns. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html

[5] Hazzard, A. (2020). Parks still a refuge for unsheltered people. Retrieved November 2020. https://www.southwestjournal.com/news/2020/07/parks-still-a-refuge-for-unsheltered-people/

[6] Chung, Y. & Grinstein-Weiss, M. (2020). Housing inequality gets worse as the COVID-19 pandemic is prolonged. Retrieved March 2021. https://www.brookings.edu/blog/up-front/2020/12/18/housing-inequality-gets-worse-as-the-covid-19-pandemic-is-prolonged/

[7] Marohn, K. (2020).  Walz announces $100 million in COVID-19 housing aid. Retrieved November 2020. https://www.mprnews.org/story/2020/07/14/walz-announces-100-million-in-covid19-housing-aid

[8] Minnesota Department of Health, Health Economics Program. (2020). Pandemic’s Impact on Health Insurance Coverage in Minnesota Was Modest by Summer 2020. https://www.health.state.mn.us/data/economics/docs/inscoverage2020.pdf

[9] Minnesota COVID-19 Response. (2021). COVID-19 Data by Race/Ethnicity. Retrieved March June 2022. https://mn.gov/covid19/data/data-by-race-ethnicity/index.jsp

[10] Kim, L., Whitaker, M., O’Halloran, A., Kambhampati, A., Chai, S. J., Reingold, A., Armistead, I., Kawasaki, B., Meek, J., Yousey-Hindes, K., Anderson, E. J., Openo, K. P., Weigel, A., Ryan, P., Monroe, M. L., Fox, K., Kim, S., Lynfield, R., Bye, E., … Wortham, J. (2020). Hospitalization Rates and Characteristics of Children Aged <18 Years Hospitalized with Laboratory-Confirmed COVID-19—COVID-NET, 14 States, March 1–July 25, 2020. MMWR. Morbidity and Mortality Weekly Report, 69(32), 1081–1088. https://doi.org/10.15585/mmwr.mm6932e3

[11] Olson, H. (2021). Leech Lake’s State of the Band Address covers tribal milestones, COVID-19 impact, vaccine rollout and more. Retrieved August 2022. https://www.redlakenationnews.com/story/2021/03/30/politics/leech-lakes-state-of-the-band-address-covers-tribal-milestones-covid-19-impact-vaccine-rollout-and-more/96953.html

[12] Brooks, J.R., Hong, J.H., Cheref, S., Walker, RL. (2020). Capability for suicide: Discrimination as a painful and provocative event. Suicide and Life-Threatening Behavior. 50(6): 1173-1180.

[13] Brooks, J.R., Hong, J.H., Madubata, L., Odafe, M., Cheref, S., Walker, RL. (2020). The moderating effect of dispositional forgiveness on perceived racial discrimination and depression for African American adults. Cultural Diversity and Ethnic Minority Psychology. 10.1037/cdp0000385.

[14] Child and Adolescent Health Measurement Initiative. 2018-2019 National Survey of Children’s Health (NSCH) data query. Data Resource Center for Child and Adolescent Health supported by Cooperative Agreement U59MC27866 from the U.S. Department of Health and Human Services, Health Resources and Services Administration’s Maternal and Child Health Bureau (HRSA MCHB). Retrieved from www.childhealthdata.org. CAHMI: www.cahmi.org.

[15] Davis, A., & Moritz, K. (2020). Structural racism and health care. https://www.mprnews.org/episode/2020/06/09/davis-structural-racism-and-health-care

[16] National Survey of Children’s Health. (2022). Indicator 4.12c: If this child received care during the past 12 months, did they receive family-centered care? Data Resource Center for Child & Adolescent Health. https://www.childhealthdata.org/browse/survey/results?q=8635&r=25&g=914

[17] U.S. Census Bureau; American Community Survey, 2020 American Community Survey 5-year estimates, Tables B17020C and S1703; using data.census.gov; <https://data.census.gov/cedsci/>; (7 July 2022).

[18] Minnesota Compass (2021). High school students graduating on time by racial and ethnic group. Minnesota Compass. https://www.mncompass.org/topics/quality-of-life/education#1-6084-g

[19] Children and Family Services. (2022). Minnesota’s out-of-home care and permanency report, 2020. Minnesota Department of Human Services. https://edocs.dhs.state.mn.us/lfserver/Public/DHS-5408Ma-ENG  

[20] Minnesota Public Health Data Access Portal. (2019). Premature birth. .

[21] Minnesota’s education system shows persistent opportunity gaps by race. (2021). Federal Reserve Bank of Minneapolis. Retrieved from: https://www.minneapolisfed.org/article/2021/minnesotas-education-system-shows-persistent-opportunity-gaps-by-race

[22] McKay, N. & McKay, M. S. (2020). Where we Stand – The University of Minnesota and Dakhóta Treaty Lands. Retrieved March 5, 2021. https://editions.lib.umn.edu/openrivers/article/where-we-stand/

[23] Minneapolis 2040 Plan. Retrieved December 2018. https://minneapolis2040.com/topics/housing/

[24] Hardeman, R., Chantarat, T., Smith, M. Karbeah, J., Van Riper, D., & Mendez, D. (2021). Association of residence in high-police contact neighborhoods with preterm birth among Black and White individuals in Minneapolis. Jama Network Open, 4(12), 1-12. doi:10.1001/jamanetworkopen.2021.30290

[25] Plain, C. (2021, April 14). Study to examine the effect of police violence on the birth outcomes for Black infants. University of Minnesota. Retrieved from: https://www.sph.umn.edu/news/study-to-examine-the-effect-of-police-violence-on-the-birth-outcomes-for-black-infants/.