Understanding the top health issues facing Milwaukee County

Background: Health is determined by complex interactions among socioeconomic factors, health behavior, health care, and physical environment. Since 2012, the Milwaukee Health Care Partnership’s triennial Community Health Needs Assessment (CHNA) has reported the top health issues identified by residents and community leaders in Milwaukee County. The CHNA serves as the foundation from which hospitals, community health centers, and local health departments develop their community health improvement strategies. Purpose: To better understand the health of Milwaukee County and what influences it. Methods: The CHNA is informed by three key sources: Community Health Survey (a 14-minute, phone-based survey of Milwaukee County residents that addresses adult/child health risks, health behaviors, and community health needs); key informant interviews (conducted with health experts and community leaders to identify community health needs, contributing social factors, and organizations best suited to address those issues); and Health Compass Milwaukee (a compilation of publicly available data, including sources mentioned above, on a recently launched website). We utilized all three sources to create the CHNA to help understand the burdens, disparities, inequities, and determinants that contribute to health issues Results: The top 5 issues of greatest concern were chronic disease, mental health, substance use, violence, and access to health care. Among chronic disease conditions, heart disease was identified as the leading cause of death in Milwaukee County, with a premature death rate of 1228 per 100,000 lives, which is higher than the rest of Wisconsin. Among mental health outcomes, suicide rates in Wisconsin jumped 55.6% from 2000 to 2017 but remained relatively level in Milwaukee County. Regarding substance use in Milwaukee County, the opioid-related overdose death counts are concerning, with an increase from 144 in 2012 to 337 in 2017. In terms of violence against individuals that inflicts physical harm, Milwaukee County (945.1 violent crimes per 100,000 individuals) has a higher rate of violence than the rest of Wisconsin (282.9). On a positive note, regarding health care access, the Affordable Care Act spurred Milwaukee County’s uninsured rate to drop from 12.6% in 2013 to 7.2% in 2017. Conclusion: Health is complex. It is our hope that this assessment and website will help amplify providers and community conversations about the importance of cross-sector collaboration for health improvement