Underlying Causes

New program to focus on social and economic factors to improve health


Looking at health from a more holistic vantage point means digging into the underlying causes of health inequality. And doing just that is key to supporting patients and community members in Milwaukee and throughout the state of Wisconsin most effectively, according to leaders at the Medical College of Wisconsin.

This broader view of health means gaining a better understanding of the effects of social and economic factors – such as a person’s neighborhood, education level, access to healthcare and potential language barriers, among others. These aspects of health are referred to as “social determinants of health.” In Wisconsin, inequities in these determinants are exacerbated because two out of every three counties are considered medically underserved.

MCW is addressing these challenging trends through its community engagement mission. According to President and CEO John R. Raymond, Sr., MD, “We cannot say that we have achieved better health without making a serious commitment to addressing health disparities and equity in the region.” To that end, a new community engagement program dedicated to this mission has launched in 2019: COME ALIVE MILWAUKEE.

COME ALIVE MILWAUKEE, the acronym for Community Empowerment and Lifestyle Intervention for Ethnic Minorities, has been in development for two years, according to principal investigator Leonard Egede, MD, MS, professor of medicine, chief of the division of general internal medicine, and director of MCW’s Center for Advancing Population Science.

“We spent two years conducting focus groups and interviews, and immersed ourselves in the central Milwaukee community to better understand its needs,” he says. Going forward, the program team will work to reduce the burden of chronic disease and eliminate health disparities in minority communities, as well as to grow the next generation of researchers.

“Chronic stress drives poor health in a community,” Dr. Egede explains. “Removing one stressor, such as access to healthcare services, doesn’t take care of all things, so we must shift the paradigm to incorporate social determinants into our clinical care models.”

With support from a $2.8 million, six-year award from the Advancing a Healthier Wisconsin Endowment (AHW), COME ALIVE MILWAUKEE will partner with churches and nonprofits (among others) to focus on social determinants when addressing health equity in the communities of 10 Milwaukee ZIP codes.

“We need to learn from responses to natural disasters,” continues Dr. Egede. “When aid is provided, there is no blame. Aid providers, who are there to help, address the necessities first – such as food, shelter and water. We need to treat communities with significant health disparities in the same way. Healthcare, criminal justice, housing, hunger, violence, education and faith-based initiatives need to all work together to address the stressors that lead to poor health outcomes.”

COME ALIVE MILWAUKEE’s mission is to lead this collaborative work by helping facilitate a coordinated strategy, forge partnerships and recruit experts with needed skills in community education and public health. The AHW award will be the foundation for a sustained commitment to Milwaukee.

“You don’t change a community in three to five years,” Dr. Egede says. “Five years is just the beginning.”

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