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Equitable efficiency: Milwaukee County researching possibility of centralizing Health Department

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MILWAUKEE — The Milwaukee County Board of Supervisors is requesting research on creating a centralized County Health Department with the goal of establishing equity.

“When we think of a health perspective, you can’t think of health without equity as well,” Dr. Ben Weston, Medical Director for the Milwaukee County Office of Emergency Mangement said. “Our goal, in the end, is to improve health. We know how close equity is tied to health.”

In 2019, Milwaukee County declared racism a public health crisis. Social determinants of health shine a glaring light in Milwaukee on the inequities that exist in housing, transportation, employment and health. Over the last year, because of the COVID-19 pandemic, those inequities were in hyperdrive with African Americans and other people of color facing vastly higher rates of infection and death.

Getting help in a time of crisis can be confusing and difficult as it stands in Milwaukee County. There are currently eleven municipal health departments, covering 951,448 residents in the county.

Milwaukee County Map
Milwaukee County is researching whether they should centralize the 11 municipal health departments, serving nearly 1 million people.

“I get tons of calls asking, 'are you the health department?'” Shakita LaGrant, Director of the Milwaukee County Department of Health and Human Services said. “As we have all of these separate health departments throughout the county, is this the best way we bring this all together under one entity and meeting people where they are to address the disparities?”

LaGrant says it is way too early to say what this could look like. The County Board of Supervisors is asking for the research to begin. Over the next five to six months, Wisconsin Policy Forum, in partnership with UW Madison Population Health Insititute, will look into four key areas:

  • How do other metro areas address racial health disparities and does their performance in this area provide clues to potential structural changes here?
  • Are there coordinated county-municipal-private sector public health models from other metro areas that might provide worthwhile ideas for Milwaukee County?
  • Is there a need for a permanent unified approach to public health in Milwaukee County to coordinate programming, planning, data collection; set common standards & priorities; and improve health equity and health improvement? What range of options exists for such an approach?
  • Is there a need for better and more formalized coordination and collaboration between public sector public health agencies and private health care providers and institutions?

“This has an opportunity for us to maximize an overall universal outreach in terms of the entire community,” Cassandra Libal, Director of the Office of Emergency Management said. “Milwaukee is broken up into several municipalities and each one has its own unique issues. We don’t want to negate that but there are ways we can look at a bigger picture of the overall health of the county and make sure those communities most in need are receiving the resources they need to address racism and overall health disparities.”

According to research by the University of Wisconsin School of Medicine & Public Health, Milwaukee County is the second least healthy county in the state. While it’s too early to tell if a centralized County health department will be in Milwaukee County’s future, this research will inevitably make way for equitable progress.

Milwaukee County 2nd least healthy in state
Milwaukee County 2nd least healthy in state

“There is so much work that needs to happen,” LaGrant said. “Just researching and then looking into those recommendations of, how do we move forward? We need to figure out how to come together and make this work to address some of those underlying root causes people are experiencing in mental health, housing, employment, transportation. All of those things are impacting people and we need to figure it out.”

This could streamline things, allowing those in need of help to go to one area.

“We need to make sure we continue to work with them,” Libal said. “It’s a collaborative effort. It’s a way to make sure we’re not redundant in different communities and share resources and maybe highlight areas of concern that may be missed because of a lack of communication are there.”

But just this research alone shows the progress being made by Milwaukee County.

Milwaukee has been called the worst city in the country for African American wellbeing, by a UWM study on the State of Black Milwaukee. LaGrant says actions like this are a step in creating more equity.

“The County Executive is really pushing towards that vision,” LaGrant said. “Through racial equity, Milwaukee will become the healthiest county in Wisconsin. That won’t happen overnight. We need to make sure we’re looking through that racial and health equity lens in all the decisions we make and making sure we have resources to do that.”

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