Okay, let's go to camera.
Good morning, whenever you're ready.
I might walk from one camera to
the other, please try not to be
distracted by me.
So right here.
Again, we're not live.
Yeah.
Okay, so we have it for the cameras.
Could you introduce yourself and
tell us where you were?
Sure, hi, I'm Paula Tran and I'm
the Division Administrator and State
Health Officer at the Division of
Public Health at the Department of
Health Services.
So Paula Tran, State Health Officer
with the Wisconsin Department of
Health Services, thank you for
joining us.
Yeah, thanks for having me.
So every five years your agency
releases this huge report
called the State Health Assessment.
What are you measuring and why?
Overall, we are measuring the
things that shape Wisconsinites'
health, as well as the health
outcome. 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.
Let's start with the problems based
on this new report.
What are the most significant health
concerns facing Wisconsinites?
Yeah, well, we know that
Wisconsinites are dying younger than
before the pandemic, and we know
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 meet it, when they need
it.
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?
Yeah, some of the barriers are costs
and access
to insurance that actually covers
all the kinds of care that they need
and costs 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 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 healthcare providers
close down or adjust just based
on the
challenges it takes to run
a healthcare 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.
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?
Yeah, 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
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
feeling and to their health
outcomes that we continue to
be challenged around
obesity,
hypertension, that cause us
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.
Another key point in your report,
you found that Wisconsinites are
dying younger than they did before
the COVID-19 pandemic.
How much younger and why is that
happening?
Well, so across the
report really looks at overall
drivers of death as
well as when we look at the very
specific populations.
So when we look at younger
populations, we know that they
are being impacted by
overdose, by accidents,
by violent crimes
and injuries, and those
things are impacting younger people
more.
Throughout the pandemic, we also
saw this introduction of COVID as
COVID-19 as a
cause of death or in a contributor
to death.
So that raised the,
rather that
decreased the overall life
expectancy for populations across
the board while we saw these other
challenges persist, especially for
young people.
So how much younger are we talking?
It is significant, but it varies
across all age groups.
And I'm sorry, I don't have that
exact number right at the top of my
fingertips.
That's okay.
So what did your report find as far
as access to health care?
What we found is Wisconsinites
are being challenged by cost,
especially, but also
proximity and finding quality
care where they need it and where
they can access it
quickly.
So transportation is a cost.
People are needing to travel
a great distance to
the types of care that they need.
And again, insurance is really
driving whether or not the
type of care they need is in their
network. And whether or not the care
that they need is in their network
is also influencing their
decisions to access those care and
the cost of that care.
Let's turn to some positive findings
now.
What are some health outcomes that
are trending in the right direction
for Wisconsin residents?
Yeah, well, around the area
of commercial tobacco use, we are
seeing declines in overall
use of commercial tabaco use, so
that is a good sign.
And that's actually an
area where policies are working to
really help make the default
choice, the easier choice
and the healthier choice for
individuals to decide to either
delay smoking entirely or to
not start.
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?
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.
Along lines of with mental health,
what did your report find?
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
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 situation.
Your support captures data from 2019
to 2024.
As we know, the pandemic began right
in the middle of that.
How did that disrupt your data
gathering and results?
Yeah, so across the pandemic, in
some areas we did see challenges and
being able to actually gather
the data.
We also saw that there
are anomalies that
likely were captured because people
were accessing unnecessary,
I'll say people were
also being asked to
not seek some care right away
if they didn't need to, especially
during the height of.
Us sheltering in place and
being at home.
So we knew that people were
not accessing that early preventive
care like they usually would.
So that did impact the actual
data that we collected because
people just weren't accessing that
care and where
data was collected in those settings
and that typical data wasn't
reflective of the actual
experiences.
The federal government under the,
let me start that one over,
the federal government under the
Trump administration has taken a
very different stance on health and
health care than previous
administrations.
How much does the State of Wisconsin
Department of Health Services
policies align with the
current federal government policies?
Yeah, so we're a state where
that takes
in a lot of resources from the
federal government.
So there are a lot our
programs that are really driven
by the directives of the federal
government. So in that case, there's
ongoing work to
negotiate and align where
we should based on our contractual
agreements with the federal
government.
And there are things that the
federal government is promoting
right now that we want to also
continue to support, right?
That. Work to make sure folks
have access to healthy food
that is not ultra-processed,
I think is a shared goal among many
related to nutrition, and
in other areas we are challenged by
really thinking about how to
follow the science and remain
focused on the
best available evidence to inform
our day-to-day work.
So,
specifically with regard to
vaccines.
There's some difference between the
federal government and the state
health department.
How do you guys work within that?
Um, that's a great example
of an area where, um, as a
department and in collaboration with
our governor's office, we've
continued to follow the best
available evidence.
Um, so we have, um maintained,
um our guidance and alignment with,
um a credible, uh,
national organizations like the
American Academy of Pediatrics, um
to really align our especially
childhood vaccinations with
those credible bodies that have
continued to, um.
Hold sight on the guidance
and where the
guidance is best supported by
evidence.
So the Wisconsin Department of
Health Services, you've got this
huge five-year report, a lot of
data.
What happens next with your findings
and how do you use this information
to make Wisconsin residents
more healthy?
So the state health assessment is
a complementary report to our state
health improvement plan and our
state assessment is step one.
Now that we've finished that, we
begin the state improvement planning
process where we use the data that
was collected in the state
assessment to then inform
priority setting.
So we are in
the process of engaging partners
now to then bring that data forward
to really think about
how to set the course for our next
state health plan our ship.
Okay, Paula Tran with the Wisconsin
Department of Health Services, thank
you for your time.
Yeah, thank you so much.
And now we get to sit here awkwardly
for 30 seconds to just do a room
tone.
So we'll just.
That's good.