Community Context

Milwaukee is home to several manufacturing companies and small- and medium-sized enterprises with a growing professional and managerial workforce. The region ranks in the top-10 areas nationwide in terms of the number of corporate headquarters per capita, and despite a strong industrial history, Milwaukee’s three largest employers are currently in the health sector. Milwaukee has remained in Democratic control over the past five years, and while the mayor has been in position since 2014, there have been several recent changes in 2021 to local leadership, including the first Black Milwaukee County Executive. 

Milwaukee is one of the most racially segregated cities in the United States and was one of the first to declare racism a public health crisis in 2019. Significant disparities by race/ethnicity continue to exist within the city. There is a lack of affordable housing and high rates of poverty. Black and Latino households earn between half to two-thirds of White households’ earnings. Wisconsin did not adopt Medicaid expansion, and Milwaukee is a federally designated medically underserved area for primary care. Residents in Milwaukee continue to experience higher rates of infant mortality, diabetes, obesity, and asthma compared to national averages.

Milwaukee’s Journey to Promote Health, Well-Being, and Equity

Five years into the Sentinel Communities Surveillance Project, various collaborations and coalitions work together to promote health.

Milwaukee’s capacity to promote health, well-being, and equity remains rooted in activities and efforts of nonprofits and collaborations in social justice and civic engagement, housing, and health sectors, including several grassroots organizations. There is no single, lead organization for health, thus efforts are mostly being led by collaborations and coalitions. Regarding the health narrative in Milwaukee, over the past five years there has been an amplification of the relationship between physical and mental health and the importance of social determinants of health. Health discussions in the city embrace a fuller appreciation of historical and structural issues concerning race, and these conversations are now showing up in city policy and in community engagement. Milwaukee’s approach to health equity has been expanding over the past five years through a combination of city investment and collaborations among community organizations.

Lessons Learned: Where is Milwaukee Five Years Later?

Milwaukee’s journey to promote health, well-being, and equity underscores the opportunity in linking race and health equity, and in encouraging the participation of nonprofit and private sectors with government action. The new or deepened collaborations that are happening because of COVID-19 provide a chance to accelerate policy and programmatic changes on behalf of health equity and the social determinants of health. Other communities can learn from Milwaukee’s approaches and lessons learned regarding moving from health disparities to a more nuanced health equity frame to inform their own journeys. Future research could consider whether this momentum around racism as a public health issue takes hold in Milwaukee across organizations and sectors, and whether and how it leads to lasting policy changes.

Milwaukee has leveraged collaborations and a focus on health equity to address long-standing factors that influence health and well-being outcomes. Yet barriers remain regarding the city’s persistent struggle with racial segregation and the impact of COVID-19 on exacerbating health inequities.

Facilitators:

  • Growing focus on health equity convened more meaningful partnerships

  • Philanthropic sector and private businesses have been instrumental

  • Data capacity to support decision-making

  • Commitment to violence prevention, understanding trauma, and mental health

Barriers:

  • Historic and structural discrimination and inequity

  • Limited funding for health from the city

  • Increase in rates of violence during the pandemic