BY JOANN PETASCHNICK
Baby boomer or millennial, insured or uninsured, in good health or suffering from chronic illness, eventually we all require health care services. The citizens of Milwaukee County are no exception.
Organizations have coalesced to study the wide array of health care needs of Milwaukee County’s residents. For example, every three years, the five major health system members of the Milwaukee Health Care Partnership (MHCP) conduct a comprehensive community health needs assessment (CHNA). Done in collaboration with the Milwaukee Health Department and 11 other municipal health departments in Milwaukee County, the assessment is based on a survey of nearly 2,000 residents, as well as input from community leaders and other data sources. It has become the foundation for the development of community health improvement strategies.
Published just last year, the most recent CHNA indicated that access to health care services continues to rank as a pressing need, while behavioral health — both mental health and substance abuse — was the top issue among key informants. The issue of violence also factored prominently in key informant feedback. “What has changed in recent years is that we in the health care provider and health policy community recognize the role that social determinants play,” says Clare Reardon, organizational advancement director of the MHCP. “Only 10 percent of individuals’ health is determined by the quality of care, while 40 percent is determined by socioeconomic factors that are outside the control of traditional health care, including income, education, housing and access to fresh food — that’s pretty important.”
Changes to health care regulations, nationally and locally, are worrisome to many people. “Right now, we don’t know how many people might lose insurance coverage, including Medicaid. The volatility in the insurance market is a big concern because coverage is the gateway to health care,” Reardon says. Uninsured people may delay seeking health care. Once they seek it, it is often in a busy emergency room because their health problems are acute by that time. “The further upstream we can go from a clinic visit, the bigger the impact on the health of an individual,” she says.
Even the ability to do something simple like exercise can be affected by socioeconomics, Reardon adds. Consider that in the city of Milwaukee, low-income individuals often live in locations that are prone to violence. “Say you have hypertension or diabetes and you live in an unsafe neighborhood. You can’t go out and walk; that exercise is not possible,” she explains. “We are trying to coordinate care and get individuals connected with the right person — the person who can help them navigate the system.”
Looking at this subject from the perspective of the health care provider, the entire state of Wisconsin is suffering from a shortage of health care professionals, including physicians, physician assistants and nurses. This, of course, has an impact on health care access and delivery for all citizens. “Retirements are outstripping hospitals’ ability to fill the vacant positions they leave behind. Wisconsin could soon see an unprecedented shortage of key health care professionals,” says Steven Rush, formerly of the Wisconsin Hospital Association (WHA). “(The problem persists) primarily because the demand for health care is increasing as baby boomers approach retirement. It’s like a double whammy: The age of our workforce is a direct reflection of the average age of our population.”
Milwaukee County’s health care needs are diverse, and more than one response is necessary. “Health care providers and organizations such as the MHCP are increasingly partnering with community-based organizations to improve access as well as help coordinate care for our underserved populations,” Reardon says.
To address the issue of a lack of health care professionals, the WHA worked closely with Gov. Scott Walker’s administration and the Wisconsin legislature to create matching grant funding for new programs and to expand existing medical residency programs. According to a statement from WHA President/CEO Eric Borgerding, “Great health care is one of the most important assets we have in our state, delivered by dedicated, highly skilled professionals. We will work with our local stakeholders and elected officials to ensure that Wisconsin remains competitive with other states to recruit and retain our health care workforce.”