Identify Goals and Strategies for Built ... - Milwaukee



Identify Goals and Strategies for Built Environment. Access to Healthy Foods, etc | |Vision: Milwaukee is a model community with healthy, safe, hopeful and empowered residents

Strategic Question | Goal

|Strategies |Possible process objectives for Action Teams

(Healthiest State Project and assessment findings) |Collaborators

|Community Themes |Data |Related Essential Public Health Services (% score) |Forces of Change:

Trends, Factors, and Events | |How can we improve the built and natural environments to foster healthy behaviors and lifestyles? |All persons will benefit from the integration of health into built and natural environments

:

|Increase physical activity through access to safe and appealing opportunities and incentives

Increase access to and consumption of healthy foods through the built environment and nutrition education and standards

Reduce and mitigate environmental contamination affecting urban gardens and brown field redevelopment

Improve outdoor and indoor air quality

Improve the cleanliness of city (streets and green spaces)

Increase comprehensive programming around energy consumption

|Physical Activity Promotion

Programs

Increase access to fitness and community centers (reduce cost and physical access)

Pedestrian safety

Better snow removal on sidewalks

Point of decision prompts (signs by elevators/escalators to use stairs)

Neighborhood watch/safety walk to create safe communities

“Safe routes to school “ program to promote walking and change city planning

Improve building accessibility (wheelchair/handicap accessible)

Policies

Offer grants for mixed use development

Increase green space accessible by foot or bike

Recreational leagues for both children and adults

Expand school-based physical activity

Gasoline tax

Workplace incentives to be active

Subsidize public transportation

Reduce health insurance premium with gym membership/use

Environmental Contamination

Programs

Pesticide Environment Stewardship Program

Nutrient Best Management Tillage

(share best practices with community gardeners)

Programs/Policies

Become involved/advocate for ground water stewardship programs

Air Quality and Comprehensive Programming

Programs

Alternative fuels initiatives

Clean cities coalition

Carpooling or ride share programs

Bus pass incentive program

Smart commute initiative

Vehicle inspection and maintenance program

Promote green pricing utility programs

Promote CDC’s healthy home model to reduce asthma and lead poisoning resulting from indoor exposure

Policies

Retrofitting buses to reduce emissions

Seek local transportation enhancement grants (bike and pedestrian program)

Credit or rebates on solar energy use

Gasoline tax

Subsidize local transportation

Work with the Office of City Planning to require the use of Health Impact Assessments before passing new city planning initiatives

General Cleanliness

Programs/Policies

Increase garbage pickups

More trash cans

Access to Healthy Foods .

Programs

After school/school gardens

Healthy, sustainable schools program

Smart growth program

Farm to school programs

Policies

Institute policies to facilitate city and community gardens

Advocate for policies that support the use of WIC dollars for fresh produce year round

Allocate funding to purchase electronic methods of payment at local farmer markets

Tax credits for locating farmer’s markets in lower income neighborhoods

Create policy around school nutrition standards

Create policy around nutritional standards for competitive foods in schools (Limit access to competitive foods in schools)

Policy regulating nutrition education standards

Competitive pricing – price non-nutritious food at higher prices

Snack taxes

Reduce/eliminate advertising of non-nutritious food/drink in schools

Label foods served in public to display nutritional value

Educational

Programming

Programs

Educate community on food safety

Place health information in common spaces of public housing

Provide taste-testing/food education

Provide patients with nutrition “prescriptions” and tools for self-assessment and recording | |Challenges

Transit cuts

Hard to get to jobs in suburbs

School buss pass policies limit transportation options for after school programs and medical care

Access to quality food

Hunger

Fitness

Pollution/water quality/lake pollution

Litter/trash/rodents

Park maintenance

Lead poisoning

Affordable housing

Assets

Farmers markets in the spring

Some walkable neighborhoods

|In 2004, 54% of City of Milwaukee renters were spending more than 1/3 of their household income on housing.10

Another estimated 42,552 poor households are renters. Of these 67% are working poor, and 18% are elderly and disabled. Most of the working families consist of single parents; out of those single parents, 47% spend more than half of their income on housing related costs, while 78% spend more than 30% of their income on housing10

WIC farmers market program not available in winter due to requirement that fruits and vegetables be locally grown.8

|EPHS 5. Develop Policies and Plans that Support Individual and Community Health Efforts (65%)

|Housing infrastructure that few residents one can afford-developers not thinking of themselves as part of the health of the community

• Existence of interstate/freeway

• Easy access to multiple forms of transportation

• Increase cost of food and other goods

• High rates of obesity

• Issue of food insecurity

• Lack of access to healthy food

• Multiple WIC sites

• Media coverage for food borne illness outbreak

• Global warming and encroachment of natural habitat

• Battle over water rights- diverting water to other regions

• Proximity to Lake Michigan

• Prevalence of outdoor recreation areas (lake, parks, etc.)

• Abundance and awareness of importance of parks and green spaces

• On the whole, city kept clean (from litter, graffiti)

• | | | | | | | | | |Racial segregation in Milwaukee

• State's largest city

• Poverty in Milwaukee

• Disparities in key health indicators (Infant mortality, teen pregnancy, homicide, insurance coverage, immunization rates)

• Health disparities disproportionately impact black men and boys

• High incarceration rates

• High prevalence of people living in poverty

• Perception of danger and crime

• High rates child abuse, domestic violence, youth violence, homicide

• Availability of guns | | | | | | | | | |Lack of ability of city to bring in new industry and new jobs

• No Child Left Behind and chaos in funding for public schools has created climate where health is considered a frill

• Need for parenting education and early childhood education programs

• Declining city population

• Migrating populations from city to suburbs

• State's largest city

• Urban development resulting in shifting population distribution causing socio-economic segregation

• High prevalence of people living in poverty | | | | | | | | | |Lack of ATODA services

• High rates of substance abuse

• Fourth in the nation for under-age drinking, must change norm

• Political debate over smoke-free venues and cigarette taxes

• Social acceptance of binge drinking and smoking, specific to Milwaukee

• Poverty in Milwaukee

• Need for parenting education and early childhood education programs

• Lack of sufficient mental health services for those in need

• Cuts in funding for mental health services

• High rates child abuse, domestic violence, youth violence, homicide

| | | | | | | | |

|Housing infrastructure that few residents one can afford-developers not thinking of themselves as part of the health of the community

• Existence of interstate/freeway

• Easy access to multiple forms of transportation

• Increase cost of food and other goods

• High rates of obesity

• Issue of food insecurity

• Lack of access to healthy food

• Multiple WIC sites

• Media coverage for food borne illness outbreak

• Global warming and encroachment of natural habitat

• Battle over water rights- diverting water to other regions

• Proximity to Lake Michigan

• Prevalence of outdoor recreation areas (lake, parks, etc.)

• Abundance and awareness of importance of parks and green spaces

• On the whole, city kept clean (from litter, graffiti)

• Senator Kohl’s experience/interest in retail food | |

Footnotes

1. Milwaukee Vital Records. 2005

2. Baker, B., Chen, V., Fillmore, C., Blair, K., Michalski, K. & Paradowski, J. Fetal Infant Mortality Review (FIMR). 2002-2004. Milwaukee Healthy Beginnings Project, Health Resources and Services Administration & Milwaukee Health Department

3. National Institute of Child Health and Human Development. Health Disparities: Bridging the Gap. 2000, reprinted 2005

4. United Way of Greater Milwaukee. If Truth be Told Report. 2006

5. Riverwest Health Initiative Riverwest Community Health Assessment, 2004-2006.

6. Levine, Marc. After the Boom: Joblessness in Milwaukee Since 2000. University of Wisconsin-Milwaukee Center for Economic Development. 2004.

7. Acevedo-Garcia, D., McArdle, N., Osypuk, T.L., Lefkowitz, B. & Krimgold, B. Children Left Behind: How Metorpoliatn Areas are Failing Americans Children. Harvard School of Public Health & Center for the Advancement of Health. January 2007.

8. Wisconsin Council on Children and Families. Start Smart Milwaukee. 2005

9. Community Health Improvement in Metcalfe and Concordia (CHIMC). “CHIMC Secondary Data Overview” 2006

10. Pawasarat, J. & Quinn, L.. Legal Action Wisconsin Housing Report. University of Wisconsin-Milwaukee Employment and Training Institute. 2007

11. Lapine, L., Larson, L., & Schmitter, A. Child Care for Children who are Mildly Ill: A Description of Perspectives from Child Care Providers, Parents and Employers. Planning Council for Health and Human Services, Inc. 2000.

12. The Wisconsin Department of Public Instruction.

13. Aurora Health Care. Aurora Milwaukee Community Health Survey 2006. In Partnership with Milwaukee Health Department & Center for Urban Population Health. Prepared by JKV Research, LLC

14. Aurora Health Care. Aurora Central Milwaukee Community Health Survey 2006. In Partnership with Milwaukee Health Department & Center for Urban Population Health. Prepared by JkV Research, LLC.

15. Wisconsin Hospital Association.

16. Wisconsin Department of Health and Family Services. Wisconsin Local Health Department Survey 2003-2004. 2005.

17. Milwaukee Health Department. Public Health Report by Aldermanic District. October 18, 2005.

18. Federal Investigation Bureau. 2005.

19. Wisconsin Department of Health and Family Services. Wisconsin Child Abuse and Neglect Report, 2005 data. Office of Program Evaluation and Planning. Division of Children and Family Services.

20. Bureau of Justice Statistics Factbook, U.S. Department of Justice. 1998

21. Wisconsin Domestic Abuse Incident Report for 2001, Office of Crime Victim Services

22. WCADV, 2000 Domestic Homicide Report

23. Wisconsin Domestic Abuse Incident Report for 2005, Office of Crime Victim Services

24. Blair, K., & Liegel, J. Death: Leading Causes for 1995-2005, City of Milwaukee. June 2007. Milwaukee Health Department.

25. Department of Health and Human Services. Wisconsin Interactive Statistics on Health.

26. Wisconsin STD program. 2004

27. Bureau of Health Information and Policy, Division of Public Health, Wisconsin Department of Health and Family Services. Wisconsin Family Health Survey: City of Milwaukee. 2005.

28. Coley, B., Hollander, G. & Seal, D. Health Disparities Among LBGT Populations In Wisconsin: A Summary Report of Needs. Diverse and Resilient & Center for AIDS Intervention and Research. 2006.

29. Centers for Disease Control and Prevention. Survnet. Data 2000-2006. accessed on the Milwaukee Health Department website health

30. Department of Workforce Development. Wisconsin Shares Subsidy Porgram. Monthly Statistics. Accessed on

. 2007. Graph only

31. Pawasarat, J. & Quinn, L.M., Addressing Barriers to Employment: Increasing Child Care Rates and the Rate Setting Process Under the Wisconsin Shares Program. University of Wisconsin-Milwaukee Employment and Training Institutes. 2002.

32. Center for Disease Control and Prevention. Youth Behavior Risk Survey.

33. Glaze LE. & James DJ, Mental health problems of prison and jail inmates. Bureau of Justice Statistics Special Report. September 2006.

34. United Way of Greater Milwaukee. “Breaking the Cycle of Poverty.” 2008.

35. Pawasarat, J. & Quinn, L. Racial Integration in Urban America: A Block Level Analysis of African American and White Housing Patterns. Employment and Training Institute. School of Continuing Education, University of Wisconsin-Milwaukee, December 2002, revised January 2003.

36. Wisconsin Department of Health and Family Services, Bureau of Health Information and Policy, Division of Public Health. Wisconsin 2001-2005.

37. Wisconsin Department of Health Services.Framework for Action to Eliminate Racial and Ethnic Disparities in Birth Outcomes. January 2009-01-16

38. Milwaukee Homicide Review Commission Interim Progress Report. May 2007.

39. Citylights. Selected health adolescent disparities data. 2007:16(2):3-14.

40. Milwaukee Fire Department. Life Threatening Penetrating Trauma Patients Transported by ALS Units. 2000-2005.

41. Wisconsin Anti-Violence Effort Educational Fund (WAVE). WAVE Report. Fall 2008: Volume 5, Issue 2.

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