Milwaukee, Wisconsin

Milwaukee, the largest city in Wisconsin, lies along the western shore of Lake Michigan at the confluence of three rivers.

Originally used by fur traders and shippers as the Great Lakes Port, the city was incorporated in 1846. Milwaukee has traditionally been known for its breweries, industrial and manufacturing might, and its waves of immigrant populations. Despite its racial diversity, Milwaukee is regarded as one of the nation’s most racially segregated metropolitan areas in the United States.

In 2015, the once prosperous city of Milwaukee was rated the second poorest major city in America. Decades of entrenched segregation and the decline of the manufacturing sector have produced neighborhoods of concentrated poverty and their associated high rates of chronic disease, depression, teen pregnancy, and low educational attainment. Partnerships have emerged that envision Milwaukee as a leader in environmentally conscious job creation, improved access to healthy, local foods, and shared transportation options.

Overview

Population and Demographics

Population: 600,000

SOURCES:
U.S. Census Bureau; photography courtesy Flickr user Jeramey Jannene, CC BY 2.0.

Context and Actions

Community Context and Challenges

In 2014, the unemployment rate in Milwaukee was 13%, nearly twice the state average (7%).
Poverty affects nearly 29% of Milwaukee residents and disproportionately affects minorities, with 37% of Black and 28% of Hispanic residents living at or below the federal poverty line, compared with 16% of white residents.
Milwaukee residents experience chronic illnesses such as asthma (15%) and diabetes (10%) at higher rates compared with state- (10%; 9%) and nation-wide (9%;10%) averages.
Among adults in Milwaukee, 18% have not earned a high school diploma, compared to 9% in Wisconsin; 21% of Black and 42% of Hispanic residents hold less than a high school diploma, compared to 8% of white residents.
Black residents are twice as likely as white residents to describe their health as fair or poor and Hispanics report symptoms of depression more than twice as often as white residents.

SOURCES:
U.S. Census Bureau. (2014). 2010–2014 American Community Survey 5-Year Estimates.

Milwaukee Community Health Survey Report (2012).

Taking Action

With their sights set on creating a healthier Milwaukee, a wide range of community partners from many sectors are working to develop a sound environmental and economic future for the city

A multi-sector redevelopment initiative launched in 2013 intertwines a road map for economic growth with efforts to preserve and enhance the city’s natural resources, now and in the future.

NOTE:
These baseline reports, created in 2016, track community programs and initiatives in their early stages and measure initial progress only. Future reports will provide more in-depth insights and analysis into this community's efforts to build a Culture of Health.

MKE Elevate

Residents’ input, alongside data and information from the city’s health assessment plan, will contribute to MKE Elevate, an ambitious plan to address community-identified issues with local resources. Based on community feedback, the overarching goal of MKE Elevate will be to build safe and healthy neighborhoods; work is underway by the Milwaukee Health Department’s Office of Violence Prevention to develop approaches that will foster safe and healthy neighborhoods.

Re/Fresh Milwaukee Sustainability Plan

Working with a wide range of community partners that include the city and county of Milwaukee, the Center for Resilient Cities, the River Revitalization Foundation, the Milwaukee Metropolitan Sewerage District, the University of Wisconsin-Milwaukee, and the Southeastern Wisconsin Regional Planning Commission, a 10-year Re/Fresh Milwaukee Sustainability Plan is targeting progress in these eight priority areas:

Buildings
Energy
Food Systems
Human Capital
Land and Urban Ecosystems
Mobility
Resource Recovery
Water

Home GR/OWN

Home GR/OWN, launched concurrently with Re/Fresh Milwaukee, was developed to increase demand for and access to healthy foods, an indicator of the city’s effort to create healthier, more equitable communities. As a step toward this goal, the city has converted city-owned vacant lots into new uses that also create a sense of neighborhood belonging for local residents.

Boosting Enrollment in Health Insurance Marketplace

Milwaukee was awarded the “Healthy Communities Challenge” for its successful efforts to raise enrollment in the federal health insurance marketplace created under the Affordable Care Act. Nearly 38,000 formerly uninsured individuals selected a health insurance plan during the open enrollment period for 2016, boosting total enrollment in the marketplace in the Milwaukee area to 89,000. The increase in enrollment was achieved through a combination of traditional and new methods, including using libraries for enrollment events, partnering with the ride-sharing company Uber to provide rides to final enrollment events, and coordinating telephone calls and outreach through Milwaukee City departments to get the message out.

Going Forward

Questions for Consideration

Despite deeply rooted economic and racial challenges, Milwaukee is leveraging partnerships to improve social and economic conditions and expand health equity for all of its residents. Ongoing progress is likely to depend on the sustained participation of private and public partners and the continued improvement in the region’s economy. Additional surveillance, data and information gathering, analysis, and reporting will examine how these partnerships are working to improve economic opportunities for all residents and address longstanding racial disparities in health outcomes.

The following questions provide opportunities for further exploration:

What progress has the Mayor’s Re/Fresh Milwaukee plan for sustainability and economic growth had on goals related to residents’ health and well-being, such as rehabilitating old buildings, expanding transit options, and increasing options for healthy, local sources of food?
To what extent can the information management resources of Milwaukee city agencies accelerate efforts for population health improvement?
To what extent has input from the city’s historically underserved Black community been sought and reflected in ambitious citywide plans?
What progress has been made on Milwaukee’s new initiative to build safe and healthy neighborhoods? To what extent is community input informing the decisions about where resources are spent?
What effect has the longstanding political friction between Wisconsin’s Republican Governor and Milwaukee’s Democratic Mayor had on efforts to direct spending to Milwaukee’s priority areas?
Does evidence indicate that Milwaukee residents with health insurance provided under the federal insurance marketplace can access health care services, especially in underserved areas?