Here & Now

Paula Tran on the Health Challenges Facing Wisconsinites

Frederica Freyberg:
Turning to health news, 20% of Wisconsinites are self-reporting poor or fair physical health, and 1 in 7 say the same of their mental health. This is according to the new state health assessment, which comes out every five years. The Department of Health Services is looking for ways to fill in the gaps. Steven Potter spoke with the state health officer, Paula Tran, for more, beginning with what the report is measuring.

Paula Tran:
Overall, we are measuring the things that shape Wisconsinites’ health as well as the health outcomes. So we’re looking at things like demographic factors: who lives in Wisconsin, where they live. We’re also measuring the main causes of death, and we’re also looking at all of the factors that really shape an individual’s ability to be healthy and well, like economic factors, looking at housing, looking at affordable access to resources that people need, like food and transportation, as well as their access to health care directly.

Steven Potter:
What are the most significant health concerns facing Wisconsinites?

Paula Tran:
Yeah. Well, we know that Wisconsinites are dying younger than before the pandemic, and we know that there’s a lot of challenges for Wisconsinites in accessing both the daily resources that they need to be healthy and well. So healthy food, having safe, secure housing, having transportation to get them to where they need, as well as having good access to affordable care where they need it, when they need it.

Steven Potter:
One of the key points in your new report is that Wisconsinites feel that there are major obstacles to them receiving health care they need to be healthy. What are those barriers?

Paula Tran:
Yeah, some of the barriers are costs, and access to insurance that actually covers all the kinds of care that they need, and cost and insurance kind of go together. And we know that most people access insurance through their employer. So if they are experiencing gaps in employment, that might cause disruptions in their insurance and therefore their access to care. When we look at care directly, we know that in parts of our state, there are gaps in kinds of care. So hospitals have closed over the last several years in more rural areas. And even in urban areas, we’re seeing clinics and other health care providers close down or just based on, you know, the challenges it takes to run a health care organization. So both getting to care in a way that’s accessible and access can be defined again, by cost, by being able to drive to the care and also having the right kind of provider for the care you need.

Steven Potter:
A large number of residents rated their own health as poor or fair, about 20% of residents said that. Why are they feeling this way?

Paula Tran:
Yeah, it again — when we look at all of the challenges that Wisconsinites are facing, we know that overall costs are rising across not just health care, but all daily living needs. So that is putting a stress on families. And because our incomes are also being impacted and not rising as quickly for some, with the inflation of other costs, Wisconsinites are being forced to choose between these really important things that they need, whether it’s putting food on the table with medications or accessing care because there’s a co-payment that they cannot afford. So all of those things are contributing to how Wisconsinites are feeling and to their health outcomes, that we continue to be challenged around obesity, hypertension that causes a whole host of chronic diseases. So there are both the drivers of health that are causing more stress for Wisconsinites and accessing the things that they need to be healthy and well are also exacerbating and allowing other health outcomes to persist.

Steven Potter:
Along the lines of mental health, what did your report find?

Paula Tran:
Yeah, we know that Wisconsinites are struggling. They’re experiencing stress, and they’re also reporting that their mental health is poor. And when they need supports around mental health, it’s very difficult to access the kind of mental health care that they need. And we know our mental health care environment has a lot of room to improve around coordinating around different kinds of care, receiving the right referrals for the care you need, and all across the care continuum, making sure we are coordinated so that at any part of the entry of that continuum, folks are accessing early and not allowing some of those challenges to persist, to become worse and potentially be in crisis situations.

Steven Potter:
Your report also measures some good things: residents who vote, volunteer, or do favors for others. Why is it important to measure these things and what did you find?

Paula Tran:
Yeah. What the current evidence tells us is communities that are more engaged and active and connected to each other, the healthier those communities are. It both helps from a mental health perspective. But when in a community, a neighbor is in need of something, they’re much more likely to be able to have community support be responsive to those needs. So there’s a lot of different reasons why community connectedness and community engagement and being civically involved helps a community stay healthier and access the resources it needs. So that’s an absolutely great finding for us that more Wisconsinites are feeling like they help others and others help them when they’re in need.