Identify Goals and Strategies for Built Environment

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

Milwaukee Vital Records. 2005
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
National Institute of Child Health and Human Development. Health Disparities: Bridging the Gap. 2000, reprinted 2005
United Way of Greater Milwaukee. If Truth be Told Report. 2006
Riverwest Health Initiative Riverwest Community Health Assessment, 2004-2006.
Levine, Marc. After the Boom: Joblessness in Milwaukee Since 2000. University of Wisconsin-Milwaukee Center for Economic Development. 2004.
Acevedo-Garcia, D., McArdle, N., Osypuk, T.L., Lefkowitz, B. & Krimgold, B. Children Left Behind: How Metorpoliatn Areas are Failing Americans Children. HarvardSchool of Public Health & Center for the Advancement of Health. January 2007. diversitydata.org
Wisconsin Council on Children and Families. Start Smart Milwaukee. 2005
Community Health Improvement in Metcalfe and Concordia (CHIMC). “CHIMC Secondary Data Overview” 2006
Pawasarat, J. & Quinn, L.. Legal Action Wisconsin Housing Report. University of Wisconsin-Milwaukee Employment and Training Institute. 2007
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.
The Wisconsin Department of Public Instruction.
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
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.
WisconsinHospital Association.
Wisconsin Department of Health and Family Services. Wisconsin Local Health Department Survey 2003-2004. 2005.
Milwaukee Health Department. Public Health Report by Aldermanic District. October 18, 2005.
Federal Investigation Bureau. 2005.
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.
Bureau of Justice Statistics Factbook, U.S. Department of Justice. 1998
Wisconsin Domestic Abuse Incident Report for 2001, Office of Crime Victim Services
WCADV, 2000 Domestic Homicide Report
Wisconsin Domestic Abuse Incident Report for 2005, Office of Crime Victim Services
Blair, K., & Liegel, J. Death: Leading Causes for 1995-2005, City of Milwaukee. June 2007. Milwaukee Health Department.
Department of Health and Human Services. Wisconsin Interactive Statistics on Health.
Wisconsin STD program. 2004
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.
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.
Centers for Disease Control and Prevention. Survnet. Data 2000-2006. accessed on the Milwaukee Health Department website
Department of Workforce Development. Wisconsin Shares Subsidy Porgram. Monthly Statistics. Accessed on

2007. Graph only

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.
Center for Disease Control and Prevention. Youth Behavior Risk Survey.
Glaze LE. & James DJ, Mental health problems of prison and jail inmates. Bureau of Justice Statistics Special Report. September 2006.
United Way of Greater Milwaukee. “Breaking the Cycle of Poverty.” 2008.
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.
Wisconsin Department of Health and Family Services, Bureau of Health Information and Policy, Division of Public Health. Wisconsin 2001-2005.
Wisconsin Department of Health Services.Framework for Action to Eliminate Racial and Ethnic Disparities in Birth Outcomes. January 2009-01-16
Milwaukee Homicide Review Commission Interim Progress Report. May 2007.
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.