1 00:00:00,000 --> 00:00:03,000 Okay, both cameras reporting, whenever you're ready. 2 00:00:03,000 --> 00:00:04,000 Great. 3 00:00:08,000 --> 00:00:12,000 I might walk from one camera to the other, please try not to be distracted by me. 4 00:00:12,000 --> 00:00:13,000 Okay. 5 00:00:13,000 --> 00:00:14,000 Okay. 6 00:00:14,000 --> 00:00:15,000 Okay. 7 00:00:15,000 --> 00:00:17,000 Again, we're not live. 8 00:00:17,000 --> 00:00:18,000 Yeah. 9 00:00:21,000 --> 00:00:22,000 Whenever you're ready. 10 00:00:22,000 --> 00:00:26,000 Okay. So we have it for the cameras. Could you introduce yourself and tell us where you work? 11 00:00:26,000 --> 00:00:34,000 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. 12 00:00:34,000 --> 00:00:39,000 So, Paula Tran, State Health Officer with the Wisconsin Department of Health Services. Thank you for joining us. 13 00:00:39,000 --> 00:00:40,000 Yeah, thanks for having me. 14 00:00:40,000 --> 00:00:45,000 So, every five years your agency really uses this huge report called the State Health Assessment. 15 00:00:45,000 --> 00:00:47,000 Where are you measuring and why? 16 00:00:47,000 --> 00:00:48,000 Yeah. 17 00:00:48,000 --> 00:00:54,000 Overall, we are measuring the things that shape Wisconsinites' health as well as the health outcomes. 18 00:00:54,000 --> 00:00:59,000 So we're looking at things like demographic factors who lives in Wisconsin, where they live. 19 00:00:59,000 --> 00:01:03,000 We're also measuring the main causes of death. 20 00:01:03,000 --> 00:01:21,000 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 healthcare directly. 21 00:01:21,000 --> 00:01:24,000 Let's start with the problems based on this new report. 22 00:01:24,000 --> 00:01:29,000 What are the most significant health concerns facing Wisconsinites? 23 00:01:29,000 --> 00:01:40,000 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. 24 00:01:40,000 --> 00:01:54,000 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. 25 00:01:54,000 --> 00:02:03,000 One of the key points in your new report is that Wisconsinites feel that there are major obstacles to them receiving healthcare. They need to be healthy. 26 00:02:03,000 --> 00:02:04,000 What are those barriers? 27 00:02:04,000 --> 00:02:14,000 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. 28 00:02:14,000 --> 00:02:25,000 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. 29 00:02:26,000 --> 00:02:51,000 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 healthcare providers close down or just based on the challenges it takes to run a healthcare organization. 30 00:02:51,000 --> 00:03:05,000 So, both getting to care in a way that's accessible and access can be defined again by costs, by being able to drive to the care, and also having the right kind of provider for the care you need. 31 00:03:05,000 --> 00:03:13,000 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? 32 00:03:13,000 --> 00:03:27,000 Yeah, again, when we look at all of the challenges that Wisconsinites are facing, we know that overall costs are rising across not just healthcare, but all daily living needs. 33 00:03:28,000 --> 00:03:41,000 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. 34 00:03:41,000 --> 00:03:53,000 Wisconsinites are being forced to choose between these really important things that they need, but whether it's putting food on the table with medications or accessing care because there's a copayment that they cannot afford. 35 00:03:53,000 --> 00:04:08,000 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. 36 00:04:08,000 --> 00:04:24,000 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. 37 00:04:24,000 --> 00:04:31,000 Another key point in your report you found that Wisconsinites are dying younger than they did before the COVID-19 pandemic. 38 00:04:31,000 --> 00:04:33,000 How much younger and why is that happening? 39 00:04:34,000 --> 00:04:43,000 Well, so across the report really looks at overall drivers of death as well as when we look at the very specific population. 40 00:04:43,000 --> 00:04:59,000 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. 41 00:04:59,000 --> 00:05:08,000 Throughout the pandemic, we also saw this introduction of COVID as COVID-19 as a cause of death or in a contributor to death. 42 00:05:08,000 --> 00:05:21,000 So, that raised the rather that decrease the overall life expectancy for populations across the board while we saw these other challenges persist, especially for young people. 43 00:05:21,000 --> 00:05:24,000 So, how much younger are we talking? Is it significant? 44 00:05:24,000 --> 00:05:32,000 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. 45 00:05:32,000 --> 00:05:33,000 That's okay. 46 00:05:33,000 --> 00:05:37,000 So, what did your report find as far as access to health care? 47 00:05:37,000 --> 00:05:50,000 What we found is Wisconsinites are being challenged by costs, especially, but also proximity and finding quality care where they need it and where they can access it quickly. 48 00:05:50,000 --> 00:05:58,000 So, transportation is a cause. People are needing to travel a great distance to the types of care that they need. 49 00:05:58,000 --> 00:06:04,000 And again, insurance is really driving whether or not the type of care they need is in their network. 50 00:06:04,000 --> 00:06:12,000 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. 51 00:06:13,000 --> 00:06:15,000 Let's turn to some positive findings now. 52 00:06:15,000 --> 00:06:20,000 What are some health outcomes that are trending in the right direction for Wisconsin residents? 53 00:06:20,000 --> 00:06:27,000 Yeah, well, around the area of commercial tobacco use, we are seeing declines in overall use of commercial tobacco use. 54 00:06:27,000 --> 00:06:41,000 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. 55 00:06:41,000 --> 00:06:44,000 Or to not start. 56 00:06:44,000 --> 00:06:52,000 You report also measures some good things, residents who vote to volunteer or do favors for others. 57 00:06:52,000 --> 00:06:56,000 Why is it important to measure these things and what did you find? 58 00:06:56,000 --> 00:07:06,000 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. 59 00:07:07,000 --> 00:07:19,000 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. 60 00:07:19,000 --> 00:07:31,000 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. 61 00:07:31,000 --> 00:07:41,000 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. 62 00:07:41,000 --> 00:07:44,000 Along lines of with mental health, what did your report find? 63 00:07:44,000 --> 00:07:57,000 Yeah, we know that Wisconsinites are struggling, they're experiencing stress, and they're also reporting that their mental health is poor. 64 00:07:57,000 --> 00:08:03,000 And when they need supports around mental health, it's very difficult to access the kind of mental health care that they need. 65 00:08:03,000 --> 00:08:16,000 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. 66 00:08:16,000 --> 00:08:34,000 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. 67 00:08:35,000 --> 00:08:39,000 The support captures data from 2019 to 2024. 68 00:08:39,000 --> 00:08:42,000 As we know, the pandemic began right in the middle of that. 69 00:08:42,000 --> 00:08:46,000 How did that disrupt your data gathering and results? 70 00:08:46,000 --> 00:08:53,000 Yeah, so across the pandemic, in some areas, we did see challenges and being able to actually gather the data. 71 00:08:53,000 --> 00:09:17,000 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. 72 00:09:17,000 --> 00:09:28,000 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. 73 00:09:28,000 --> 00:09:37,000 And where data was collected in those settings and that typical data wasn't reflective of the actual experiences. 74 00:09:38,000 --> 00:09:50,000 The federal government under the Trump administration has taken a very different stance on health and healthcare than previous administrations. 75 00:09:50,000 --> 00:09:58,000 How much does the state of Wisconsin Department of Health Services policies align with the current federal government policies? 76 00:09:58,000 --> 00:10:05,000 Yeah, so we're a state where that takes in a lot of resources from the federal government. 77 00:10:05,000 --> 00:10:11,000 So there are a lot of our programs that are really driven by the directives of the federal government. 78 00:10:11,000 --> 00:10:21,000 So in that case, there's ongoing work to negotiate and align where we should based on our contractual agreements with the federal government. 79 00:10:21,000 --> 00:10:28,000 And there are things that the federal government is promoting right now that we want to also continue to support, right? 80 00:10:28,000 --> 00:10:37,000 The 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. 81 00:10:37,000 --> 00:10:49,000 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. 82 00:10:50,000 --> 00:10:57,000 So specifically with regard to vaccines, there's some difference between the federal government and the state health department. 83 00:10:57,000 --> 00:11:00,000 How do you guys work within that? 84 00:11:00,000 --> 00:11:09,000 That's a great example of an area where as a department and in collaboration with our governor's office, we've continued to follow the best available evidence. 85 00:11:09,000 --> 00:11:38,000 So we have maintained our guidance in alignment with credible national organizations like the American Academy of Pediatrics to really align our specialty childhood vaccinations with those credible bodies that have continued to hold sight on the guidance and where the guidance is best supported by evidence. 86 00:11:38,000 --> 00:11:43,000 So Wisconsin Department of Health Services, you've got this huge five-year report, a lot of data. 87 00:11:43,000 --> 00:11:49,000 What happens next with your findings and how do you use this information to make Wisconsin residents more healthy? 88 00:11:49,000 --> 00:11:56,000 Yeah, so the state health assessment is a complimentary report to our state health improvement plan, and our state health assessment is step one. 89 00:11:56,000 --> 00:12:06,000 Now that we've finished that, we begin the state health improvement planning process where we use the data that was collected in the state health assessment to the informed priority setting. 90 00:12:06,000 --> 00:12:18,000 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 improvement plan, our ship. 91 00:12:18,000 --> 00:12:22,000 Okay, Paula Tran with the Wisconsin Department of Health Services, thank you for your time. 92 00:12:22,000 --> 00:12:24,000 Yeah, thank you so much. 93 00:12:25,000 --> 00:12:32,000 And now we get to sit here awkwardly for 30 seconds to just do a room tone. 94 00:12:32,000 --> 00:12:34,000 So we'll just.