Although a planned fire drill abruptly ended the first feedback session earlier this month for MKE Elevate, the Community Health Improvement Plan, several attendees continued to discuss the health needs of residents as they exited the building down five flights of stairs, fire alarm blaring.
Residents now have one more opportunity (on Nov. 1) to give their input and help determine the final content of the Milwaukee Health Department’s comprehensive health plan for the city, which will be implemented over the next five years.
Many people who attended the first feedback session on Oct. 5 at UWM’s Joseph J. Zilber School of Public Health, called the meeting constructive and important.
Elise Papke, senior special lecturer at Zilber and its assistant dean of accreditation assessment and community engagement, said the sessions are important because they signify the Health Department’s “commitment to health equity and elimination of disparities.”
For Justin Rivas, the community health initiatives director for the Milwaukee Health Care Partnership, in a city like Milwaukee, which has a “history of discrimination and is hyper-segregated,” addressing disparities is the very job of a health department.
“You can’t really improve the health of an entire population if you are not closing the gaps and improving the health of those who have the most need,” he said. The partnership is a nonprofit organization that aims to connect Milwaukee residents with services.
Confronting the challenges
The Health Department staff who are responsible for facilitating MKE Elevate are realistic about the challenges inherent in addressing such disparities.
“I think there’s always going to be a need for improvement and always going to be gaps that need to be filled,” said Langston Verdin, director of health strategy for the Milwaukee Health Department. But, Langston argued, this is exactly what is “special about MKE Elevate ... it allows us to think about how we are being responsible.”
Although most attendees at the Zilber gathering were involved in health care professionally one way or another, this is not a requirement. In fact, MKE Elevate staff intentionally planned other sessions in different parts of the city to reflect its demographic diversity.
On a general level, MKE Elevate is both a set of general health priorities for the city and strategies for accomplishing these priorities.
The priorities are determined by the phase the process is currently in, the information and data gathering phase, and the feedback sessions are the last part of that phase – the last source of input – before the Health Department analyzes it all to see which three to five priorities are most important for the city’s residents and what strategies can be implemented to accomplish the priorities.
Possible priorities include a wide variety of issues, ranging from expected things such as drug use, exercise and immunization to more systemic influences on health, such as the ones attendees Papke and Rivas had in mind, including health care access, educational opportunities, food affordability and even reliable Wi-Fi.
After the selection of priorities, action committees will be created to carry out the strategies, and a steering committee will help oversee the work of the action committees.
The work of the action and steering committees will be done over the course of five years, from 2023 to 2028. Rivas said he hopes to be on an action committee because this is “the most important part of the process. If we are not moving data into action, we are not ever really going to improve the community’s health.”
This is the Health Department’s second MKE Elevate cycle. The first cycle took place from 2017 to 2022, and its priorities were economic security; fairness and inclusivity; and mental health.
But the Health Department was severely affected by the pandemic, which then significantly hampered MKE Elevate, its own evaluation report stated, because it led to “… internal staff vacancies, partner agency turnover, pivoting MHD operations to COVID response, and exacerbated health disparities experienced by our community.”
Nevertheless, the evaluation report provided analysis of each priority, by comparing several different indicators within each priority at the start of the cycle with the same indicator at the end of the cycle. Some of the indicators used to gauge economic security, for example, included homeownership, food security and access to early child care.
The results for each priority were mixed – some indicators within each priority improved, and others got worse.
For example, homeownership went down, but access to food for low-income residents went up.
In addition to the pandemic and its related challenges, Rivas said the Health Department must confront a larger challenge.
“Upstream causes of poor health,” like economic inequality and educational disparities, “took a hundred years of policies and practices to create.”
That means it is “really hard to, in a myopic view, tell how well the city performed in the last five years,” Rivas said.
For more information
For those interested in attending a feedback session, registration links can be found here.
For people who do not attend a feedback session, there will still be many ways to participate as the project proceeds.
In the next couple of weeks, there will be a form to sign up to be on an action team and the steering committee, and MKE Elevate staff can be reached directly by email at firstname.lastname@example.org and on social media – on Facebook, Instagram and Twitter. There also is a monthly newsletter that will provide updates.